VVDA Application

Complete the Application Below
Fill out the application in full with as much detail as possible. Be sure all contact information is accurate, as this is how we will communicate with you.
Application Review
Our team will review your application to ensure you are a good fit for the program and committed to the expectations of the course.
Next Steps Notification
If selected, you will receive an email with enrollment instructions and payment information. If you are not selected, you will still receive communication from our team.

Important Note:
Spots are limited, and applications are reviewed on a rolling basis. Completing your application does not guarantee acceptance.

We’re excited to learn more about you and your interest in starting a career in dental assisting through VVDA!

Name

Date of Birth

Phone Number

Address

City

State

Zip Code

Do you have your high school diploma or GED? If not, when do you expect to receive it?

Are You a US Citizen?

If not, are you authorized to work in the US?

In a few words, why do you want to become a dental assistant? (For example: consistent job, better work-life balance, helping people, etc.)

Are you able to commit to the 13-week, fast-paced course (including the online work from home prior to the weekly hands-on class)?

How did you hear about us? If you were referred, write their name here!

What questions can we answer for you?