CDAS - Careers In Dental Assisting School  
CDAS
7700 W. Madison Street
River Forest, Illinois, 60305
office : 708.366.6767
fax : 708.366.6762
 info@cdaschicago.com


If you would rather submit your application by mail, please click here to download our newest catalog and application in PDF format. You will need Adobe Acrobat Reader installed on your computer to view and print the catalog and application. Adobe Acrobat is available as a free download by clicking here.




  

ONLINE REGISTRATION APPLICATION

Enrollment is open to individuals with high school diplomas or an equivilent GED certificate and available to men and woman over the age of 18 or minors with the consent of a parent or guardian.

You may apply and enroll with CDAS using the form below. When you are finished, please click the Submit button and a CDAS representative will contact you to complete the registration process.

NOTE: Please fill out the following form completely and accurately. Incorrect or missing information can delay the registration process.

Required fields are BOLD
Our non-discrimination policy can be viewed here.

APPLICANT DATA:      
ENROLLMENT FOR:   
       
FULL NAME      
     
ADDRESS 1   ADDRESS 2  
   
CITY   STATE ZIP-CODE
 
PHONE (HOME)   PHONE (WORK)  
   
DATE OF BIRTH   SOC. SEC. #  
   
EMAIL      
     
       
       
       
PRIOR EDUCATION:      
HIGH SCHOOL DIPLOMA      
       
GED      
LIST HIGHEST GRADE COMPLETED:      
       
SOME COLLEGE      
SPECIFY:      
       
DENTAL EDUCATION      
SPECIFY:      
       
NAME OF HIGHEST SCHOOL ATTENDED   YEAR OF GRADUATION
   
       
       
       
PROGRAM INFORMATION:      

 Please click HERE for all program specific fees and information
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UNDERSTANDINGS:


As a student of CDAS, I understand that:

1. The school does not guarantee employment following graduation.
2. The school reserves the right to terminate a student’s training for failure to abide by the attendance policy, failure to maintain satisfactory academic progress, failure to abide by the school’s rules and regulations, and for other reasons as detailed in the school catalog.
3. Textbooks and other supplies as detailed in the school catalog are provided by the school, as needed and that I am paying for these items under the heading “textbook & lab fee” which charge is included in the total charges for the program.
4. The school does not guarantee the transferability of its credits to any other institution.
5. Any notification of withdrawal or cancellation must be made in writing.
6. This agreement is a legally binding instrument when signed by you and accepted by the school. Your signature on this agreement acknowledges that you have been given reasonable time to read and understand it and that you have been given a catalog including a description of this program including all material facts concerning the school and the program of instruction which are likely to affect your decision to enroll.

       
       
STUDENT SIGNATURE:   DATE:  
   
NOTICE: By typing my name here I certify that I have read, understood and agree to my rights and responsibilities, that the institution’s cancellation and refund policies have been clearly explained to me and that I have a copy of this agreement (available here).      
       
PARENT / GUARDIAN (IF APPLICABLE)      
     
       
       
 

 
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