Ortho
Program

$1,250.00

Student Name (First & Last)(Required)

Student Email(Required)

Student Address(Required)

Street Address Address Line 2 City Province Postal Code (A1A 1A1)

Phone (no - or brackets please)(Required)

Designation(Required)

Regulatory Body(Required)

Practice Permit Number(Required)

Employer: Dentist Name

Employer: Dentist Office Name

Are you an alumni of Risio Institute?(Required)

Dental Assisting Program Applications

Are you interested in applying for the Dental Assisting Program?