Coronal Polishing 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.
  • Registration closes at 5 p.m. on Friday ONE WEEK BEFORE the course date.  Payments received after the cut off will have to move to a later course date.

**You must have a patient for this course (possibly two)**

**ALL course participants are required to provide their own slow speed handpiece.  Please do not enroll more employees than you have available handpieces.**

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

How to Upload Documents

Course Schedule