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

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 6 Online Learning (2024)

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Session 6 Hands-On Training (2024)

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Session 7 Online Learning (2024)

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Session 7 Hands-On Training (2024)

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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.

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DateOnlineLearningAdmin

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DateHandsOnTrainingAdmin

Program Description

Dental assisting: 11 modules with a total of 105.5 clock hours

Session 6 (2024): Online Learning Start Date

Session 6 (2024): Hands-on Training Start Date

Session 7 (2024): Online Learning Start Date

Session 7 (2024): Hands-on Training Start Date

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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Hidden Hands-on Training Start Date

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 (LMS) 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 (no specific brand or design is required but they must be black). UDA allows a maximum stipend amount of up to $40.00 (including tax) per student. Each student can choose to spend more than this on their scrubs, but the difference of any amount above $40 is the responsibility of the student.

Online e-Learning Platform (LMS), RHS online course for DANB exam, Coronal Polishing online course for DANB exam, Supplies, & Equipment: $500.00

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

Basic Life Support Cardiopulmonary Resuscitation (CPR) certification: $60.00

Tuition: $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 pre-payment, or full tuition payment. There are no fees or interest associated with this option.

Standard Payment Plans: Weekly or bi-weekly payment options. Down payment required prior to first day of class. Students may elect to start paying early. Program must be paid in full prior to receiving certificate of completion. There are no fees or interest associated with this option.

Customizable Payment Plans: Weekly, bi-weekly, or monthly payment options based on selected variables using Unity’s online tuition payment calculator. Program must be paid in full prior to receiving 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: Payments are made monthly to a third-party financing partner. Student must be approved for financing prior to first day of class. A down payment is required to be eligible for this option. Interest and/or fees may be incurred. Early payoff, prepayment, or extra payments are subject to the terms and conditions of the financing partner.

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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Cancelation & Refund Policy

Denial: An applicant denied by UDA is entitled to a refund of all monies paid.

Three-Day Cancellation: An applicant who provides written notice of cancellation within three days (excluding Saturday, Sunday, and federal and state holidays) of signing an enrollment agreement is entitled to a refund of all monies paid, except for any credit card or debit card transaction fees. UDA shall provide 100% of the refund (less transaction fees) no later than 30 days of receiving the notice of cancellation.

Other Cancellation: An applicant requesting cancellation more than three days after signing an enrollment agreement and making an initial payment, but prior to entering the UDA program, is entitled to a refund of all monies paid, except for any credit card or debit card transaction fees.

Leave of Absence (LOA): If a student needs to take a LOA (maximum four (4) weeks) they must first notify the board in written format, describing why they are taking time off, how long they expect to be absent, and their expected return date. The board will review each individual case and accept or deny the request. If the request is accepted, a plan will be 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 the board, then the refund policy (defined in Section 8) will be followed. If the request is denied, then the student will be refunded monies as listed in the refund policy. Each student will only be 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 below. If they wish to re-enter the program, they will have to reapply and pay the full fee.

Students Initials*

Refund After Commencement of Classes

Procedure for Withdrawal / Withdrawal Date
1. Students withdrawing permanently from the course after the commencement of classes are required to initiate contact with a representative from Unity Dental Assisting to let them know of their desire to withdraw. A pre-exit interview, either verbally or in writing, will be conducted to gain insights into the reasons for withdrawal and to discuss any applicable refunds according to the refund policy. If no viable accommodations can be identified to support the student in remaining enrolled in the course, and the decision to withdraw persists, the student will be officially dropped from the course. This process involves the submission of an Exit Interview Form, confirming the student's understanding of the withdrawal procedure and expressing their desire to withdraw. The withdrawal date, as indicated in the refund policy section, will be used to enforce the applicable refund policy.
2. For a student who is on authorized LOA, the withdraw date is the date the student was scheduled to return from the LOA and failed to do so.

Tuition Charges/Refunds

After the commencement of classes, the tuition refund amount shall be determined as follows:

Percentage of Clock Hours Attended	Tuition Refund Amount
10% or less	90%
More than 10% and less than or equal to 20%	80%
More than 20% and less than or equal to 30%	70%
More than 30% and less than or equal to 40%	60%
More than 40% and less than or equal to 50%	50%
More than 50%	No refund required

The percentage of clock hours attended is determined by dividing the total number of clock hours elapsed from the student’s start date to the student’s last day of attendance, by the total number of clock hours in the program.

Refunds: Refunds will be issued within 30 days of the date of student notification, or date of school determination (withdrawn due to absences or other criteria as specified in the UDA Catalog), or in the case of a student not returning from an authorized LOA.

Holder in Due Course Statement: Any holder of this consumer credit contract is subject to all claims and defenses which the debtor could assert against the seller of goods or services obtained pursuant hereto or with the proceeds, hereof Recovery hereunder by the debtor shall not exceed amounts paid by the debtor (FTC Rule effective 5-14-76).

Students Initials*

Student Acknowledgements

I hereby acknowledge receipt of UDA’s Catalog dated 01/21/2025 (today’s date), which contains information describing the program offered and equipment/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.

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 meet the requirements of the payment plan I selected before a certificate of completion is awarded.

Students Initials*

I 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 designated online coursework (except for the final exam) in a timely manner prior to entering hands-on training. I understand that each student selects and signs up for a specific hands-on training class and is required to first complete the designated online coursework to be eligible for their selected hands-on class. I understand that if a student does not complete the designated online coursework within six months of the online learning start date and prior to the hands-on training class they selected, UDA reserves the right to:

Require the student to retake all designated online coursework, or
Move the student to a different future hands-on class, or
Dismiss the student from the program. If dismissed for this reason, the student is entitled to a refund according to the policy outlined in the section, Refund After the Commencement of Classes

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 or attorney fees incurred by Unity Dental Assisting.

My signature below signifies that I have read and understand all aspects of this agreement and do recognize my legal responsibilities regarding this contract.

Students Initials*

Student Name

Date

Student Signature*

Parent / Guardian Name

Date*

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*

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

Cancelation & Refund Policy

Refund After Commencement of Classes

The Student Understands

Student Acknowledgements

Contract Acceptance

Dental Assisting

Tuition & Financing