Sealant General Application

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  • This method is intended for those needing to pay by CHECK or DIRECT DEPOSIT (i.e. schools or state, government, or tribal agencies). IF YOU WISH TO PAY BY CREDIT CARD or eCHECK please use one of the online payment applications.
  • Space in the course is NOT guaranteed until payment is received and may require moving to a later course date.
  • Payments must be postmarked by the registration deadline or a late fee will be required.

**You must have a patient and extracted teeth for this course**

Employment Verification Form (MUST be signed by both the employing dentist and the applicant)

How to Upload Documents

Course Schedule