Fillable Dental Assistant Program (Century College)

Fill Online, Printable, Fillable, Blank Dental Assistant Program (Century College) Form

Use Fill to complete blank online CENTURY COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Dental Assistant Program (Century College)

On average this form takes 15 minutes to complete

The Dental Assistant Program (Century College) form is 7 pages long and contains:

  • 0 signatures
  • 22 check-boxes
  • 51 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Century College

BROWSE CENTURY COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Dental Assistant Program
Spring 2021
The demand for Certified and Licensed Dental Assistants exists with good placement, salary and benefits. Dental
Assistants participate in a variety of tasks that include chairside assisting, patient education, polishing teeth, taking
radiographs, making study models, and preparing business forms. Career opportunities exist in an assortment of dental
offices and public institutions. To be successful as a Dental Assistant you must like working with people, enjoy doing
multifarious duties, and have good verbal and written communication skills. Personal qualities needed to succeed
include: punctuality, dependability, organization and ability to work as a team member. The Dental Assistant major is
accredited by the Commission on Dental Accreditation of the American Dental Association.
a) If you are a new Century College student, complete the Century College Application including the $20 application
fee. Please note: Applicants to the Dental Assistant program must be admitted into Century College to be eligible
for admission to the Dental Assistant program. All applicants must be in good academic (GPA of 2.0 and above)
and financial standing with Century College to be eligible to apply to the program.
b) Complete the ACCUPLACER Course Placement Test if needed
c) Complete English Composition I (ENGL 1021) or transfer equivalent with a grade of C or better.
d) Complete One Goal 1 Communication class (COMM 1021, 1031, 1041, or 1051 at Century College) or transfer
equivalent with a grade of C or better.
NOTE: Goal 1 Communication Electives will not fulfill the requirement.
e) Complete the Century College Dental Assistant Application.
f) Complete the Century College Dental Assistant Program Applicant Checklist.
g) Submit an official high school transcript or an official GED transcript. All applicants must provide official proof of
graduation from an accredited high school or GED center prior to the application deadline; copies or facsimiles
will not be accepted. Transcripts from outside the USA must go through an international evaluation and be
submitted to Century College by the application deadline. Please do not assume Century already has a high school
transcript for you if you are a current student. All transcripts are due by the application deadline.
h) Submit official transcripts from all vocational, college and university institutions previously attended; copies or
facsimiles will not be accepted. The exception is other Minnesota State transcripts; we will have
access to those once you apply to the college. Transcripts from outside the USA must go through an
international evaluation and be submitted to Century College by the application deadline.
Deadline for Application
Term Deadline
Spring Semester August 14, 2020
Submit applications to: Admissions Office, Century College
3300 Century Avenue North
White Bear Lake, MN 55110
Applications must be submitted prior to the date stated above or postmarked by the application deadline.
Applicants must be in good academic and financial standing with the college by the application deadline to be
eligible for selection. Applicants on academic suspension must have their suspension lifted prior to the application
deadline or your application will not be considered. Applicants with outstanding financial obligations must be in
good standing prior to the deadline.
Application Requirements
century.edu | 651.773.1700
century.edu | 651.773.1700 | last updated:
4/6/2020 RC
GPA Requirement: Applicants must have a minimum Century College 2.0 GPA to apply to the program. The GPA will be
calculated based on the Minnesota Transfer Curriculum (MnTC) guidelines, and Century college-level curriculum.
Applicants must also have a minimum MnTC GPA of 2.0 to qualify for the program. Other types of credits, including but
not limited to: occupational curriculum, Pass/Fail, computer skills, learning lab, study skills, English for Speakers of
Other Languages (ESOL) courses and developmental education will not be calculated in the GPA. GPA will be calculated
on all program course requirements whether taken at Century College or transferred in from other colleges. The GPA
requirement also applies to all coursework taken after application up to the start of Dental Assistant program classes.
Century College ACCUPLACER Course Placement Test
The ACCUPLACER Course Placement Test should be taken at least two weeks prior to the application deadline. Please
contact the Testing Center at 651-779-3352 or visit the Testing Center website at www.century.edu/admissions/
testing-center to register to take ACCUPLACER. Please keep in mind that the tests may only be taken twice in a twelve-
month period. If testing a second time, students will be assessed a $10 retest fee.
Additional accommodations may be provided through the Access Center. Call 651-779-3354 to determine if you qualify
for services. Students must know their Century College student ID number and bring a current photo ID when testing.
Applicants who meet any of the standardized test requirements below in Reading will be exempt from the Reading
Comprehension portion of ACCUPLACER. Documentation must be provided to the Testing Center prior to the application
deadline. Also note the Next Generation Accuplacer scores that began in January as well.
If your scores place you below college-level, you will need to complete the developmental coursework indicated by
ACCUPLACER before you are eligible to apply.
ANY one of the following minimum scores are required for placement into college-level.
century.edu | 651.773.1700
Exemptions to testing requirements are in accordance with college policy. Please contact the Testing Center at 651-779-
3352 or Transfer Student Services at 651-779-3908 for details.
century.edu | 651.773.1700
Complete the Dental Assistant Program Applicant Checklist
After completing ACCUPLACER, students should complete the Dental Assistant Program Applicant Checklist on page 5
of this packet. Developmental coursework indicated by ACCUPLACER results must be completed prior to applying to
the Dental Assistant program.
Applicants are required to have completed both ENGL 1021 or transfer equivalent and a Goal 1 Communication course
to be eligible to apply (Communication Elective courses will not fulfill requirement). Coursework in-progress must be
completed prior to the application deadline.
Transcripts
All applicants are required to submit official high school transcripts which include graduation date. GED holders must
submit an official GED transcript. The degree granting institution must be an accredited agency. High school graduates
from another country must use the company WES or ECE to have an international evaluation of their high school
transcript completed and submitted to Century College.
To be considered an official transcript, it must be submitted in one of the following ways:
- Submitted through Parchment
- Submitted in-person in a signed, sealed envelope by the high school
- Mailed in a signed, sealed envelope by the high school
- For WES/ECE transcript evaluations, transcript must be submitted (in-person or ground mail) to the Admissions
Office in a sealed envelope from WES/ECE
Applicants with post-secondary education must submit official transcripts from all vocational, college and university
institutions previously attended. Applicants who have attended a Minnesota State institution(s) do not need to submit
official college transcripts.
All documents must be received prior to the application deadline.
Selection and Notification
Applicants meeting the minimum admission requirements will be evaluated and ranked on criteria including, but not
limited to, the following:
Completion of English Composition I (ENGL 1021 at Century College) with a grade of A, B or C
Completion of a Goal 1 Communication course with a grade of A, B or C
12 or more credits taken at Century College
12 or more college-level transfer credits completed at an accredited college/university
Awarded alternate status for the previous selection (Students must apply in the subsequent selection period to
obtain awarded alternate status).
The highest-ranking students are selected for the program and the remaining qualified applicants are placed
on an alternate list. Once classes begin, the alternate list is no longer in effect. Those not admitted to the
program must reapply for the next term.
All applicants will be notified by mail of their status in the program 4-6 weeks after the application deadline.
N O T E : T h i s m a y c h a n g e t o e m a i l . Applicants must maintain a current address with the
Admissions Advisor managing the program. Failure to do so may result in forfeiture of your place in the class. Due to
the high volume of applications, requests regarding application status cannot be honored.
Please be aware that this program has limited enrollment. If accepted, you will be asked to return an acceptance
agreement to reserve your place in the class. Applicants not submitting their agreement form before the deadline
will forfeit their place in the program.
century.edu | 651.773.1700
Human Services Background Study
Minnesota Law requires any individual having contact with patients to complete a human services background study, including
fingerprinting, prior to starting the clinical experience and also to get licensed. An individual may be disqualified from having patient
contact and would not be permitted to participate in the clinical experience. Contact the Minnesota Board of Dentistry and the
Minnesota Department of Human Services with any questions.
Social Security Notice
Many colleges/universities, including Century College, use Social Security numbers for student identification purposes on student
records. Providing your Social Security number is voluntary. If you do not provide this number, your application will still be
processed. This data is requested for purposes of administration, program evaluation and consumer and alumni data. Your number
also may be used to create summary information about system programs through data matches with other state agencies.
Data Privacy Notice
The college is asking you to provide information that includes private and/or confidential information under state and federal law.
You are not legally required to provide the information the college is requesting; however, the college may not be able to effectively
process your application if you do not provide sufficient information. With some exceptions, unless you consent to further release of
private information, access to this information will be limited to school officials, including faculty who have legitimate educational
interests in the information. Under certain circumstances, federal and state laws authorize release of private information without
your consent: (1) to other schools in which you seek to enroll, or are enrolled, if you are first notified of the release; (2) to federal,
state and local officials for purposes of program compliance, audit or evaluation; (3) as appropriate in connection with your
application for, or receipt of, financial aid; (4) to your parents, if your parents claim you as a dependent student for tax purposes; (5)
if the information is sought with a subpoena, to an organization engaged educational research or accrediting agency. Minnesota
State institutions abide by the provision of Title IX and other federal and state laws forbidding discrimination on the bases of sex,
race, color, national origin or handicap and all other state and federal laws regarding equal opportunity.
Immunization Information
Vaccination for Hepatitis B and a Mantoux Test will be required prior to clinical internships.
Additional Requirements While Enrolled in the Dental Assistant Program
Students must be currently certified in CPR by the end of their first semester in the Dental Assistant program.
Students must maintain a C average or higher to remain eligible for the program.
Policy Information
A copy of the program’s policy on hazardous materials, bloodborne and infectious diseases is available upon request or by visiting:
http://www.osha.gov/SLTC/bloodbornepathogens/index.html
century.edu | 651.773.1700
Dental Assistant Program Applicant Checklist
Please complete the following checklist. All items under the “Application Requirements” heading must be completed
prior to the application deadline (August 14
th
, 2020 for Spring Semester 2021) or your application will be denied.
APPLICATION REQUIREMENTS: All items must be completed before the application deadline. All courses completed
must be reflected on official transcripts. If you are in-progress of any required courses, updated transcripts reflecting
final grades must be received no later than the application deadline.
YES
NO
Have you ever attended Century College? If no:
Have you submitted the required Century College Application with the $20 application fee to the
Admissions Office? (Note: a college application must be on file before your Dental Assistant application can
be processed. This Dental Assistant application is NOT a substitute for the Century College Application form.
You must be fully admitted to Century College to be eligible to apply to the program.)
Do you have an official final high school transcript or official GED transcript from an accredited
institution on file with the college? You are responsible for providing proof of graduation prior to the
application deadline.
Have you taken the ACCUPLACER Course Placement Test for placement in Reading? Or submitted
ACCUPLACER scores from another institution? Assessment test scores are required to determine program
readiness. The placement requirement is: College-level Reading
Exemption to the Reading assessment will be given in accordance with college policy. Please contact the
Testing Center at 651-779-3352 or Transfer Student Services at 651-779-3908 for details.
Will you have completed all developmental coursework for Reading indicated by the assessment test
before the application deadline? If NO, please do not submit this application at this time.
Have you requested official transcripts from all post-secondary institutions attended? Transcripts
must be current with grades posted for all terms completed prior to the deadline and must be
received in a sealed envelope from the originating institution prior to or by the application deadline.
Are you in good Academic and Financial standing at Century College? If you are on Academic or
Financial Suspension from any institution, including Century College, your suspension and/or financial
hold must be cleared prior to the application deadline or your application will not be considered.
Will you complete ENGL 1021- English Composition I (Century College course) or transfer equivalent
with a grade of C or better by the application deadline? If NO, please do not submit this application
at this time.
Will you complete a Goal 1 Communication course by the application deadline? Communication
Elective courses will not fulfill requirement. If NO, please do not submit this application at this time.
Applicant Signature
I hereby certify that the information provided on this application form and in all other admission application materials is complete, accurate, and
true to the best of my knowledge. I understand that there may be more qualified applicants than available space in the class and that completion
of application requirements does not guarantee acceptance.
Signature
Date
Admissions Office
3300Century Avenue North
White Bear Lake, MN 55110
This application is for:
Please use black or blue ink only
Dental Assistant Application Form
Spring
Semester
2021
Fall 2020 Alternate #
Name (Last,First, Middle, Maiden)
Century Student ID number or StarID
Permanent Address City State
ZipCode
Home Phone
Email Address Cell Phone
Educational Record: Names of secondary schools, colleges and technical schools attended:
High School attended or GED City State
Graduation
Month
Year
All applicants must have an official high school transcript or GED certificate on file to be eligible for admission.
Have you ever attended any college?
Yes
No
Have you ever attended CenturyCollege?
Yes
No
Colleges, technical or
City State
Dates
Certificate, degree or
other post-secondary schools
From
To diploma received
Please contact each college and request an official transcript be sent directly to Transfer Student Services at Century College.
Applicant Signature
I hereby certify that the information provided on this application form and in all other admission application materials
is complete, accurate, and true to the best of my knowledge.
Signature Date
NOTICE
Admission is granted without regard to race, creed, color, sex, age, national origin or handicap. This institution abides by the provisions of Title IX,
federal legislation forbidding discrimination on the basis of sex and by all other federal laws regarding equal opportunity.
.
Note: Federal and state legislation requires that the contents of student files be open to review by the student. Application forms, high school
transcripts, test date, letters, and recommendations that are sent as part of any application for admission will be open to the student's review upon
request.
The college recognizes email as an official means of communication. We reserve the right to email applicants with information regarding
their application.
C
e
n
t
u
r
y
C
o
l
l
eg
e
i
s
a
m
e
m
b
e
r
o
f
t
h
e
M
i
nnes
o
t
a
S
t
a
t
e
sy
s
t
e
m
.
W
e
a
r
e
a
n
a
ffi
r
m
a
t
i
v
e
a
ct
i
on
,
equ
a
l
opp
o
r
t
u
n
i
t
y
e
m
p
l
oy
e
r
an
d
ed
u
c
a
t
o
r
.
T
h
i
s
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Dental Assistant Program (Century College)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 26 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document