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APPLICATION FOR REGISTRATION
CERTIFIED LEVEL II DENTAL ASSISTANT

The following is required for licensure:

1. Completed notarized application form [ www.nbdental.com/forms/eng-DA_app.pdf ] (Acrobat PDF format). Please make sure your application is notarized by a commissioner for oaths or notary public (lawyer).

2. A copy of a diploma from the accredited school, and if applicable, a copy of the diploma from another dental assisting program which the applicant completed.

3. A National Dental Assisting Examining Board Certificate (Level II).

4. A dental assistant who possesses a National Dental Examining Board certificate (Level II) who is a graduate from a school which is not accredited by the Commission on Dental Accreditation of Canada shall successfully complete, as of January 1, 2009, the NDAEB clinical practice evaluation (CPE).

5. A cheque made payable to the New Brunswick Dental Society for registration fee of $155.00 This amount represents a one time $30.00 registration fee and your annual license fee of $125.00. Credit cards not accepted. Annual fees are not pro-rated or refunded. Licences are valid for the calendar year January 1st to December 31st.

6. Proof of current membership with the New Brunswick Dental Assistants' Association, NBDAA, P. O. Box/C. P. 8997, Shediac N.B., E4P 8W5 Tel: 1-866-530-9189

7. Please provide a letter of good standing from the Provincial Licensing Board, if you are presently licensed to practise in another province.