Butte County Career Technical Education Center

2491 Carmichael Dr #500, Chico, CA 95928

Registered Dental Assistant Program Application

Instructions:

This application must be completed electronically (hand written applications will not be accepted).
Application packet must include:
 Completed Application
 Verification of high school diploma or equivalent
 Reference Letter (optional and recommended)

optional and recommended

Emergency Contact Information:

Education:

Please list schools attended. Attach a separate sheet of paper if necessary.

PDF or Word Files Only

example: high school = 12 years

MM/DD/YYYY - MM/DD/YYYY

MM/DD/YYYY - MM/DD/YYYY

MM/DD/YYYY - MM/DD/YYYY

Work Experience:

Include paid and volunteer experience. Please attach a separate sheet if necessary. Related experience may not be a requirement for admission; however, we seek individuals who are motivated and understand the employment conditions of the occupation.

MM/DD/YYYY - MM/DD/YYYY

MM/DD/YYYY - MM/DD/YYYY

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I declare that the information and documents submitted in conjunction with this application are true and correct to the best of my knowledge and that I composed my personal statement by myself. I acknowledge that it is my responsibility to notify CTE of any subsequent changes regarding information provided. I understand that obtaining a license or certification may require a background check.

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Butte County CTE does not discriminate on the basis of race, color, national origin, age, religion, political affiliation, gender, mental or physical disability, sex orientation, genetics, or any other basis protected by federal, state or local law, ordinance or regulation, in its educational program(s) or employment.

Personal Statement:

Please answer the following questions.

Personal Characteristics & Requirements

Class begins August 21, 2023, and meets Monday through Friday from 8:15am to 2:45pm at 2491 Carmichael Drive, Suite 200, Chico, CA, 95928

In March, students begin their community classroom placement (unpaid clinical training). Your schedule will vary at this point. You will attend class on Mondays from 8:00am to 12:00pm and complete 265 hours at your community classroom training site.
Please click here for Personal Characteristics

I have received and agree to the job requirements provided in the Personal Characteristics & Requirements document for this program.
Required