Register for Classes

Please complete and submit the form below to register for a course with the Dental Careers Institute.
The office will contact you to process payment.

DCI Course Registration Form
First Name
Last Name

Course Information


Please note that e-mail is not a secure form of communication. Medical information placed here may not be confidential. Please use this form to send your contact information, and we will respond to your inquiry using a secure method. This form should not be used by children under the age of 18.