Student Application

  • Student Information

  • Date Format: MM slash DD slash YYYY
  • Education History

  • Select the highest level of education received.
  • DateIssuing AgencyCity & State 
  • Date (to/from)Major or DegreeGPA/Credits Earned 
  • If you have attended more than one college or training institution, please provide additional details here.
  • Please provide a copy of your highest degree earned OR GED test scores. These items are required for every student application.
    Drop files here or
    Accepted file types: jpg, pdf, doc, txt, png.
  • Work Experience

    List previous health-related work experience.
  • PositionDates (to/from)Responsibilities 
  • PositionDates (to/from)Responsibilities 
  • Medical Conditions

    List any current medical conditions that may prevent you from performing dental assistant responsibilities.
  • By typing your name, you acknowledge the submission of your application to Bartram Dental Assisting School.
  • Bartram Dental Assisting School is not affiliated with any other public or private university or College in Florida or elsewhere. Upon completion of coursework, Bartram Dental Assisting School does not guarantee employment or salary in a given field of study. Any jobs or salaries mentioned are given as examples of potential employment, not a representation of a guaranteed income.

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Student Application