Dear Dental Assistant Applicant,

Dental Assistant 254-867-4864 Fax: 254-867-2239 3801 Campus Dr. I Waco, TX 76705 www.tstc.edu

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,

Dental Assistant Certificate

Semester 1 Lecture Lab Total Credit

DNTA 1213 Emergency Management 2 1 48 2

DNTA 1305 Dental Radiology 2 3 80 3

DNTA 1351 Dental Office Management 2 2 64 3

DNTA 1415 Chairside Assisting 2 4 96 4

Total Hours 8 10 288 12

Semester 2

DNTA 1245 Preventive Dentistry 1 3 64 2

DNTA 1453 Dental Assisting Applications 2 4 96 4

DNTA 1660 Clinical-Dental Assistant ° † 0 0 336 6

Total Hours 3 28 496 12

Grand Total 784 24

° 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.

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 http://www.waco.tstc.edu/admissionslanding 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 1st series ii. Hepatitis B injection 2nd series iii. Hepatitis B injection 3rd 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

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 http://www.anylabtestwaco.com/. 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:

Drug/Background Screening Guidelines:

1st Drug Screening – Entrance Requirement into Program

2nd 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

2nd 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

 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.

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.

Application Form

Dental Assistant Program

3801 Campus Drive

Waco, TX 76705

254.867.4864

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: ________________________ E-mail 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

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

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)______________________________________________

General Information

What will my class schedule look like the 1st and 2nd 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