NEBDN Dental Nurse Course Registration form

Course

Title

First Name (as it appears on your passport)

Last Name (as it appears on your passport)

Email Address

Phone Number

WhatsApp number (If you don't have one, you must download it)

Date of Birth

Full Address including Post Code

Nationality

Are you currently working as a Dental Nurse?

Name of the Clinic

Part Time or Full Time

Do you have a criminal record?

Education (Name of School/College/University)

Work Experience

Are you allowed to live and work in the UK?

Do you require a work permit or visa to work in the UK?

Do you have a National Insurance Number?

Your National Insurance Number

How did you hear about us?

Declaration Declaration I accept to pay monthly course fees every month, 150 per month, regardless of if I am currently working or not. I understand that my course ends in January 2024 (meaning if for any reason you want to extend the course, then the monthly fee of £100 per month will be applied as well as any exam deferral or re-sit fees or any other NEBDN admin fees. (This includes not being prepared for exam, failing the exam, requesting to take the exam later)). I understand that if I don't pay monthly fees every month, my course will be discontinued. I understand that finding and securing trainee dental nurse placement can take up to 6 months (depending on your location, days, and hours that you can work and distance you willing to travel). I understand that Dental Tutors do not provide any guarantees in finding a placement. I understand that any fees paid to Dental Tutors are non-refundable. I accept to pay the exam fee of 485 in one full payment as soon as I start working as a trainee dental nurse. I declare that I have completed this application truthfully and to the best of my ability.