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We’re so excited you’re considering Unity for your Dental Assistant training!

After you submit the application below, we will create your student profile and you will be a step closer to saving a seat in one of our upcoming classes.

Please Note: Completion of this form does not finalize your enrollment in our program. All students are required to select a payment plan and follow the payment requirements for their specific plan prior to finalizing enrollment.

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Student Details

First Name*

Last Name*

Permanent Address*

City*

State*

Zip*

Email*

Student Date of Birth*

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Date of Birth (administrative)

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Age

Cell Phone*

Home Phone

Student ID

Select Your Session*

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Session 1 Online Learning

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Session 1 Hands-On Training

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Session 2 Online Learning

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Session 2 Hands-On Training

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Session 3 Online Learning

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Session 3 Hands-On Training

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Session 4 Online Learning

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Session 4 Hands-On Training

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Session 5 Online Learning

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Session 5 Hands-On Training

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Session 6 Online Learning

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Session 6 Hands-On Training

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Session 7 Online Learning

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Session 7 Hands-On Training

Minimum Age Requirement: You must be at least 17 years of age to enroll in Unity's Dental Assistant training program.

A certificate of completion will be awarded upon completion of Unity’s Dental Assisting program. This includes meeting the performance levels required for graduation. All financial obligations must be met, and all accounts must be in good standing before a certificate of completion and student transcript is issued to the student.

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DateOnlineLearningAdmin

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DateHandsOnTrainingAdmin

Program Description
Dental Assistant Training: 11 modules with a total of 95.5 clock hours
Session 1: Online Learning Start Date

Session 1: Hands-on Training Start Date

Session 2: Online Learning Start Date

Session 2: Hands-on Training Start Date

Session 3: Online Learning Start Date

Session 3: Hands-on Training Start Date

Session 4: Online Learning Start Date

Session 4: Hands-on Training Start Date

Session 5: Online Learning Start Date

Session 5: Hands-on Training Start Date

Session 6: Online Learning Start Date

Session 6: Hands-on Training Start Date

Session 7: Online Learning Start Date

Session 7: Hands-on Training Start Date

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Hidden Online Learning Start Date

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Program Tuition, Costs, & Fees (Read before proceeding)
Total Program Cost: $4,450
Each student is provided with the necessary clinical supplies, dental equipment, and technology needed to complete the program and successfully achieve passing scores. This includes full access to Unity’s proprietary online e-learning system containing the program curriculum and other valuable tools and resources. No physical textbook is required or mandated to pass the program. All students are required to purchase QTY (1) black scrub top and QTY (1) black scrub bottom from Unity’s approved vendor/uniform store. No specific brand or design is required but they must be the color black. UDA allows a maximum stipend amount of up to $40.00 per student including tax. Each student can choose to spend more than this on their scrubs from the approved vendor/uniform store, but the difference of any amount above $40.00 is the responsibility of the student.

Dental supplies & equipment: $560.00

Scrubs (color: black top, black bottom): $40.00

Tuition & Online e-Learning Platform: $3,850.00

Students Initials*

Payment Plans & Financing Options
All students must enroll online at https://www.unityda.com and students are required to pay by choosing from one of the below payment options. The following payment and financing options are available to all students of Unity.

Pay in Full: Program must be completely paid for prior to starting classes. With this option, students may be eligible for tuition discounts based on seasonal specials, early tuition prepayment, or full tuition payment. There are no fees or interest associated with this option.

Standard Payment Plans: Weekly or bi-weekly payment options. A down payment is required for enrollment and must be received prior to the first day of class. Students may elect to start paying early. Program must be paid in full prior to receiving a certificate of completion. There are no fees or interest associated with this option. If a balance is due at the end of the course, the certificate of completion may be held until the outstanding tuition balance is satisfied. Employers can request confirmation of a student’s graduation directly from Unity Dental Assisting.

Customizable Payment Plans: Weekly, bi-weekly, or monthly payment options based on selected variables using Unity’s online tuition payment calculator. A down payment is required for enrollment and must be received prior to the first day of class. Program must be paid in full prior to receiving a certificate of completion. Students may elect to start paying early. There are no fees or interest associated with this option. If a balance is due at the end of the course, the certificate of completion may be held until the outstanding tuition balance is satisfied. Employers can request confirmation of a student’s graduation directly from Unity Dental Assisting.

Financing Option: Monthly payments made to a third-party financing partner. Application and approval are required before enrollment can be completed. A down payment is required to be eligible for this option. Provisions required by the lender must be adhered to and are an agreement between the student and lender. The student is responsible for understanding and complying with lenders terms and conditions.

All payments going directly through Unity Dental Assisting will be automatically charged to the card used for the first payment transaction. A confirmation receipt for each transaction will be sent to the student’s email.

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Cancellation & Refund Policy
NRS 394.449 Requirements of policy for refunds by postsecondary educational institutions.

Each postsecondary educational institution shall have a policy for refunds which at least provides:

That if the institution has substantially failed to furnish the training program agreed upon in the enrollment agreement, the institution shall refund to a student all the money the student has paid.

That if a student cancels his or her enrollment before the start of the training program, the institution shall refund to the student all the money the student has paid, minus 10 percent of the tuition agreed upon in the enrollment agreement or $150, whichever is less, and that if the institution is accredited by a regional accrediting agency recognized by the United States Department of Education, the institution may also retain any amount paid as a nonrefundable deposit to secure a position in the program upon acceptance so long as the institution clearly disclosed to the applicant that the deposit was nonrefundable before the deposit was paid.

That if a student withdraws or is expelled by the institution after the start of the training program and before the completion of more than 60 percent of the program, the institution shall refund to the student a pro rata amount of the tuition agreed upon in the enrollment agreement, minus 10 percent of the tuition agreed upon in the enrollment agreement or $150, whichever is less.

That if a student withdraws or is expelled by the institution after completion of more than 60 percent of the training program, the institution is not required to refund the student any money and may charge the student the entire cost of the tuition agreed upon in the enrollment agreement.

If a refund is owed pursuant to subsection 1, the institution shall pay the refund to the person or entity who paid the tuition within 15 calendar days after the:

Date of cancellation by a student of his or her enrollment;
Date of termination by the institution of the enrollment of a student;
Last day of an authorized leave of absence if a student fails to return after the period of authorized absence; or
Last day of attendance of a student, whichever is applicable.

Books, educational supplies or equipment for individual use are not included in the policy for refund required by subsection 1, and a separate refund must be paid by the institution to the student if those items were not used by the student. Disputes must be resolved by the Administrator for refunds required by this subsection on a case-by-case basis.

For the purposes of this section:
The period of a student’s attendance must be measured from the first day of instruction as set forth in the enrollment agreement through the student’s last day of actual attendance, regardless of absences.
The period of time for a training program is the period set forth in the enrollment agreement.
Tuition must be calculated using the tuition and fees set forth in the enrollment agreement and does not include books, educational supplies or equipment that is listed separately from the tuition and fees.

As used in this section, “substantially failed to furnish” includes canceling or changing a training program agreed upon in the enrollment agreement without:
Offering the student a fair chance to complete the same program or another program with a demonstrated possibility of placement equal to or higher than the possibility of placement of the program in which the student is enrolled within approximately the same period at no additional cost; or
Obtaining the written agreement of the student to the specified changes and a statement that the student is not being coerced or forced into accepting the changes, unless the cancellation or change of a program is in response to a change in the requirements to enter an occupation.

Three-Day Cancellation Policy
If a student cancels his or her enrollment before the start of the training program or no later than three (3) days after completing enrollment, the institution shall refund to the student all the money the student has paid.
Cancellation may occur when the student provides a written notice of cancellation to the campus. This can be done electronically, by mail, or by hand delivery. The written notice of cancellation, if sent by mail, is effective when deposited in the mail properly addressed with proper postage. The written notice of cancellation need not take any particular form and, however expressed, it is effective if it shows that the student no longer wishes to be bound by the Enrollment Agreement.

Leave of Absence (LOA): If a student needs to take a LOA (maximum four (4) weeks) they must first notify in written format, describing why they are taking time off, how long they expect to be absent, and their expected return date. UDA will review each individual case and accept or deny the request. If the request is accepted, a plan is implemented to place the student in the next available class where he/she left off in the program. If the student does not return on the specified date agreed upon by student and UDA, then the refund policy (defined above) is followed. If the request is denied, then the student will be refunded money as listed in the refund policy. Each student is only allowed to take one LOA during their enrollment in the program, and the time cannot exceed four (4) weeks). If the student needs to take a longer period off, they will be refunded their monies based on UDA’s refund policy listed above. If they wish to re-enter the program, they will have to reapply and pay the full fee.
Students Initials*

The Student Understands
UDA does not accept credit for previous education, training, or work experience.

UDA does not guarantee job placement to graduates upon program completion or upon graduation.

UDA reserves the right to reschedule the program start date when the number of students scheduled is too small.

UDA will not be responsible for any statement of policy or procedure that does not appear in UDA catalog.

UDA reserves the right to discontinue any students’ training for unsatisfactory progress, nonpayment of tuition, or failure to abide by school rules.

UDA does not guarantee the transferability of credits to a college, university, or institution. Any decision on the comparability, appropriateness, and applicability of credits and whether they should be accepted is the decision of the receiving institution.

This document does not constitute a binding agreement until accepted in writing by all parties.
Students Initials*

Student Acknowledgements
I hereby acknowledge receipt of, and fully understand UDA’s Catalog with an effective date of March 1, 2024, which contains information describing the program offered and equipment and supplies provided. UDA’s Policies and Procedures and the UDA Catalog are included as a part of this enrollment agreement, and I acknowledge that I have received a copy of these documents and understand them to their fullest extent.
Download UDA's Catalog
Students Initials*

I have carefully read and received an exact copy of this enrollment agreement.
Students Initials*

I understand that UDA may terminate my enrollment if I fail to comply with attendance, academic, and financial requirements, or if I disrupt the normal activities of UDA. While enrolled in UDA, I understand that I must maintain satisfactory academic progress as described in UDA’s Catalog. My financial obligation to UDA must be paid in full before a certificate of completion will be awarded.
Students Initials*

I also understand that UDA does not guarantee job placement to graduates upon program/course completion or upon graduation.
Students Initials*

I acknowledge and agree to complete all online learning prior to my hands-on training class, and within three (3) months of the online learning start date. I understand that if I do not complete all online learning prior to the start date of my hands-on class, UDA reserves the right to move me to a different future hands-on class at their discretion. If I do not complete the online learning within three (3) months of the online learning start date, UDA reserves the right to dismiss me from the program. If I am dismissed for this reason, I am subject to UDA’s refund policy.
Students Initials*

All students and former students of Unity Dental Assisting who participate in an externship are expected to behave in a professional and ethical manner, acting with the absolute highest level of honesty, integrity, and reliability. In addition to conforming to these policies and standards, all current and former UDA students are expected to treat every externship site representative, potential employer, and dental team member(s) with the same courtesy and respect that would be required for any professional setting.
Students Initials*

I have reviewed each section of the enrollment agreement and had the opportunity to ask questions prior to signing the enrollment agreement:

Staff answered my questions about the enrollment agreement and catalog sufficiently.

I do not have any questions concerning the enrollment agreement or catalog.
Students Initials*

Contract Acceptance
I, the undersigned, have read and understand this agreement and acknowledge receipt of a copy. It is further understood and agreed that this agreement supersedes all prior or contemporaneous verbal or written agreements and may not be modified without the written agreement of the student and UDA Official. I also understand that if I default upon this agreement I will be responsible for payment of any collection fees incurred by Unity Dental Assisting.

My signature below signifies that I have read and understandall aspects of this agreement and do recognize my legal responsibilities regarding this contract.
Students Initials*

Student Name*

Date*
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Student Signature*
Parent / Guardian Name

Date*
MM slash DD slash YYYY

Parent / Guardian Signature
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Representative’s Certification: I hereby certify that the student named above has been interviewed by me and in my judgment, meets all requirements for acceptance as a student. I further certify that there have been no verbal or written agreements or promises other than those appearing in this agreement.
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Unity Dental Assisting Representative*

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Steve's Signature

First Choice
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Date*
MM slash DD slash YYYY

Comments
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Apply now

Hurry! Classes start soon and are filling up quickly.

Let's start this journey together! Just complete the form below and we'll reach out with the next steps.

Student Details

Program Description

Program Tuition, Costs, & Fees (Read before proceeding)

Total Program Cost: $4,450

Payment Plans & Financing Options

Cancellation & Refund Policy

The Student Understands

Student Acknowledgements

Contract Acceptance

Dental Assisting

Tuition & Financing

Apply now

Hurry! Classes start soon and are filling up quickly.

Let's start this journey together! Just complete the form below and we'll reach out with the next steps.

Student Details

Program Description

Program Tuition, Costs, & Fees (Read before proceeding)

Total Program Cost: $4,450

Payment Plans & Financing Options

Cancellation & Refund Policy

The Student Understands

Student Acknowledgements

Contract Acceptance

— NEXT CLASS STARTS —DECEMBER 9, 2024

SPECIAL OFFER!gET $1,000 OFF TUITION

— NEXT CLASS STARTS —
DECEMBER 9, 2024

SPECIAL OFFER!
gET $1,000 OFF TUITION