Hands-on dental assisting education in Tempe, Arizona(602) 388-0028

Complete your enrollment packet.

Fill out the entire packet securely online. Your Social Security number is not requested here; the school will collect it in person if needed. Jean Reblitz or Deanna Dickerson will complete the school-only section after your packet is received.

Step 1 · Pay the $200 registration feeUse Square to reserve your place. Refunds follow the enrollment agreement.
Pay securely with Square

Step 2 · Fill out the packet belowComplete the applicant fields, review the agreements and add your signatures. A copy is sent to DASA when you submit.

DASA Digital Enrollment Packet

Please complete every required applicant field before selecting Submit.

If the packet does not appear, open it directly in Jotform.