Dear Dental Assistant Applicant,

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1 Dental Assistant Fax: Campus Dr. I Waco, TX Dear Dental Assistant Applicant, Welcome, we are very proud of the excellent Dental Assistant Program offered here at TSTC, and we are glad you wish to be a part of it! This packet of information has been prepared to help guide you through the application process. Our program is an accelerated, two-semester, certificate program offering hybrid courses. These hybrid courses are a combination of hands-on labs and online assignments which can be completed from your home computer. Students can expect to spend much of their time studying and preparing for each course. Advanced reading levels, high comprehension skills, superior customer service and digital dexterity are vital to your success. This program requires students who are self-motivated and organized with excellent study habits and dedication. We are excited about being a part of your decision to join our program which will put you on the path to becoming a Registered Dental Assistant. Best Wishes, Charlotte Fickens, CDA, RDA, BAAS Program Chair, Dental Assisting

2 Dental Assistant Certificate Semester 1 Lecture Lab Total Credit DNTA 1213 Emergency Management DNTA 1305 Dental Radiology DNTA 1351 Dental Office Management DNTA 1415 Chairside Assisting Total Hours Semester 2 DNTA 1245 Preventive Dentistry DNTA 1453 Dental Assisting Applications DNTA 1660 Clinical-Dental Assistant Total Hours Grand Total Course designated as capstone course. Course with external learning experience. Please Note: Due to safety reasons students may not enroll in DNTA 1305 or DNTA 1660 while pregnant. Dental Assistants are a critical part of a successful dental team. If you enjoy working with your hands, are an effective communicator, a great listener and want the responsibilities that come along with a professional career, dental assisting might be for you. The Dental Assistant program at Texas State Technical College offers the necessary training needed to enter the field. Students will learn to set up exam rooms, measure blood pressure, expose radiographs, take impressions, pour molds and fabricate temporary crowns. The United State Department of Labor states that dental assisting is among the fastest growing professions in the health provider field. Dental Assistants are in high demand throughout the nation and as the population ages and the need for health care grows, this trend is expected to continue. Salaries for Registered Dental Assistants average from $8.50 to $14.00 per hour in the Waco/Temple/Killeen area, and can be as high as $36,000 per year in metropolitan areas such as Austin, Houston or DFW.

3 How Do I Apply? Step 1: A. Apply to Texas State Technical College Waco. Complete the application on the TSTC website utilizing the online application system. Visit and click Apply button. B. Provide proof of immunization against bacterial meningitis. This law does not apply to students age 22 and over, or to students who are enrolled only in online classes. C. Request official transcripts, from high school and each college previously attended, to be sent to the Admissions and Records office. D. If necessary, meet with a financial aid representative. E. Meet with a Success Coach for advisement and potential testing. Submission of the completed college application does not guarantee acceptance into the Dental Assistant Program. Step 2: A. Complete the Texas State Technical College Dental Assistant Program Application Form. B. Complete the Drug/Background Screening Consent Form C. Obtain an official copy of immunization record containing: i. Hepatitis B injection 1 st series ii. Hepatitis B injection 2 nd series iii. Hepatitis B injection 3 rd series iv. Tetanus-Diphtheria-Pertussis within past 10 years v. Measles, Mumps and Rubella 2 series vi. TB skin test (negative result) - current within the past year, must be current when starting clinical practicum vii. Varicella or date of chicken pox disease D. Obtain a copy of current CPR card in basic life support. Must be valid until three months after anticipated graduation date.

4 Step 3: A. At the time of registration for the fall or spring semesters, all forms or documentation listed in STEP 2 must be brought to the Dental Assistant Program for further advisement. During the advising stage, you will submit to a drug and background screening. These screenings will be administered by Any Lab Test Now. Follow the link for more information You will have a two-hour window to submit to the screening. Drug/Background screening fee is $49, and all costs will be incurred by the student. Upon receipt of the drug screening results, you are to return to the Dental Assistant department to complete the registration process. (40 students will be accepted per semester, on a first-come, first-served basis, with sufficient documentation.) B. You will be given a billing statement by the instructor after your classes are entered into the computer during the registration time. You will then proceed to the Student Services Center to reconcile your bill. Afterward, you can purchase the necessary textbooks required for class and obtain your Tech One card. Step 4: Attend a MANDATORY Dental Assistant Orientation meeting the Monday prior to the first class day. The meeting will start at 9 a.m. in the Dental Assistant Program.

5 Drug/Background Screening Guidelines: 1 st Drug Screening Entrance Requirement into Program 2 nd Drug Screening Entrance Requirement in the Clinical Practicum Background Screening Entrance Requirement into Program (Used for advisement only in acquiring Registered Dental Assistant License) Incoming students should initiate a drug screen ONLY upon direction from the department. Drug/Background Screening Cost: Drug/Background Screening: $49 2 nd Drug Screening: $29 with a coupon, see DA department for coupon All students will be responsible for the cost of each screening. Drug Screening Results Negative Screen Student is eligible to register for classes and/or clinical placement. Positive Screen New applicants who test positive for drugs will not be accepted into the Dental Assistant Program. All students testing positive will not be eligible to re-apply for a minimum of 12 months. Second semester Dental Assistant students who submit a positive drug screening will be administratively withdrawn from all Dental Assistant related courses immediately. Students will also adhere to campus disciplinary actions as defined in the Student Code of Conduct. After all disciplinary sanctions have been satisfied and the student has met with the Dental Assistant Department Chair, the student may be eligible for re-enrollment after a 12 month period and required to re-start the program. This does not guarantee re-admission into the program. A positive drug screen is any instance in which a drug screening report shows a positive test for one or more of the drugs on the panel.

6 Failure to submit to drug screening A first semester student will not be eligible for enrollment. Second semester students who fail to undergo the drug screening in the time required will be administratively withdrawn from all Dental Assistant related courses immediately. Positive for prescription drugs: Students currently taking medication as prescribed by a physician are required to bring, at the time of the screening, a pharmacy issued up-to-date medication list as supporting documentation. This list will be turned into the personnel at Any Lab Test Now at the time of screening. If the student cannot provide supporting documentation, they will pay an extra fee for a Confirmation Drug Screening. All information and test results received by TSTC Waco will become a part of the students official educational record and will be protected through the Family Educational Rights and Privacy Act.

7 Application Form Dental Assistant Program 3801 Campus Drive Waco, TX Answer ALL questions. Please print legibly. Complete in blue ink. Name: [ ] Mr. [ ] Miss [ ] Mrs. [ ] Ms. First Middle Last Maiden Mailing Address: Number & Street or PO Box City State Zip Physical Address (if different from above): Date of Birth Home Phone: Cell Phone: Business Phone: Address: In case of emergency notify: Name Relationship Address: Phone: Number & Street City State Zip Education Did you graduate from high school or obtain a GED? High School GED Name of high school: Year graduated or received GED: Have you previously attended a technical school, college or university: yes no If you answered yes to the above question, list all schools of higher learning that you have attended: Name of Institution City Dates To/From Degree

8 Work Experience Begin with most recent: 1. Name of Company: Complete Address: Telephone #: Dates Employed: From To Supervisor s Name: Nature of Job Duties: Reason for leaving: 2. Name of Company: Complete Address: Telephone #: Dates Employed: From To Supervisor s Name: Nature of Job Duties: Reason for leaving: I understand that as a Dental Assistant Student, I will be exposed to blood and bodily fluids. Texas State Technical College will not be held responsible for injury sustained during clinical experiences. As a student, I am to carry my own medical, accident and liability insurance. Proof of such insurance must be kept on file in the Dental Assistant Program Office. I also understand that as a Dental Assistant student I will be required to obtain the Hepatitis B vaccination series and maintain a current tetanus and tuberculosis test on file. I understand that as a student I must comply with state and federal HIPAA privacy protection policies. I further understand that to determine my status for admission, officials of Texas State Technical College will rely upon the information submitted herein. I certify that the information in this application is complete and correct and understand that the submission of false information is grounds for rejection of my application, withdrawal of offer of my acceptance, cancellation of enrollment or appropriate disciplinary action. TSTC Dental Assistant Programs comply with all institutional, local, state and federal regulations on ionizing radiation, hazardous material, HIPAA privacy policies and blood borne and infectious diseases. I hereby certify that the information contained in this application is true and complete to the best of my knowledge. Signature of Applicant Date Texas State Technical College (TSTC) is an affirmative action/equal opportunity employer. Applicants are considered on the basis of qualifications without regard to gender, age, race, color, creed, religion, national or ethnic origin, veteran status or the presence of a non-job-related disability or any other legally protected status.

9 Drug/Background Screening Consent Form As a student applying for entry into the Dental Assistant Program at Texas State Technical College Waco, I understand that I will be required to submit a Drug/Background Screening prior to registration of classes, and a second drug screening prior to placement in a clinical practicum rotation. I also understand that my participation in the DA program is contingent upon my agreement to undergo substance screening with negative results. I further understand that if my test results are positive for illicit drugs, I will be administratively withdrawn from all Dental Assistant related courses and will not be eligible to re-apply for a minimum of 12 months. I hereby authorize Any Lab Test Now to conduct such screening and to provide the results to Texas State Technical College. I release Texas State Technical College, any person affiliated with Texas State Technical College, and any institution or person conducting the screening, from liability herein. Student s Signature Date Student s Name (Please Print) Witness Signature Witness Name (Please Print) Drug Test Facility/Any Lab Test Now/5174 W. Waco Dr. Waco, TX 76710

10 General Information What will my class schedule look like the 1 st and 2 nd semester? All classes are offered in a morning or afternoon period. Our department offers some flexibility which will allow students to maintain a part-time job if they desire. You are expected to attend all lab or hands-on training while your bookwork will be completed from your home computer. Expect to spend six to eight hours per week to complete the necessary work for each course. Your second semester, you are required to complete two clinical rotations of six weeks each, along with course work for other classes. The student is responsible for providing his/her own transportation and food cost during these rotations. Can I work a full-time job while in the program? It will become very difficult to fulfill all course work required for each course and maintain a full-time job. Do I have to know how to read? Yes, reading is a very important part of your success in this program. Most of the dental textbooks require a high level of reading and comprehension skill sets. How much does the program cost? As an estimate, the program will cost between four to six thousand dollars. What is the dress code? All students are required to wear scrubs when attending labs in the DA building. Students are free to select any type and color of scrubs to wear to labs. Clinical students are required to wear TSTC scrubs when completing their rotations. Tennis or nursing shoes are required when attending labs or clinical rotations. What documents should I bring when registering? Dental Assistant Program Application Drug/Background Screening Consent Form Official Copy of Immunizations Copy of Current CPR card in basic life support

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