This is for NEW STUDENTS registering for the Dental Coronal Polishing Class. A PAYMENT MUST BE MADE IN ORDER TO ENROLL IN THE CLASS. For assistance, please contact our Adult Education Office at 510-293-2910 or

ROP Application - Dental Coronal Polishing

Emergency Contact Info

Demographic Info

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Refund and Withdrawal

Refund Policy: Choose your class carefully. Refunds are not automatic. Deposit fee of $500 for 6-Month Accelerated Electrical Class is non-refundable. For all other classes, registration fee of $70 is non-refundable. Full refund less registration fee/ deposit is allowed if we are notified prior to the start of the class. A student may withdraw from class and request for a refund by certified mail or by email. If refund request is sent via certified mail, please send to Attention: Adult Education - Registrar, Eden Area ROP, 26316 Hesperian Blvd., Hayward CA 94545. If by email, please send to The effective date of cancellation is the date postmarked or time stamp.
Once a class has started, refunds are calculated as follows:
• If a student paid in full at the start of the class, a withdrawal prior to the midpoint of the class will allow 50% of fee refunded. After the midpoint of the class, there will be no refund allowed.
• If paid in installments, there will be no refund allowed.
An installment fee of $25 will be added for installment payment
A late fee of $25 will be accessed when passed the due date.

I hereby certify that all statements on this application are true to the best of my knowledge and belief. If accepted into an Eden Area ROP Adult Program, I understand that any untrue statements on the above application may be considered cause for dismissal. In the event you do not make your lab fee payment you will be dropped from the class, your certification (if applicable) will be withheld, and you will NOT be able to re-enroll until your outstanding balance is paid in full. My signature below certifies that I have read, understood, and agreed to my rights and responsibilities, and the refund and withdrawal policy.

I understand the refund & withdrawal policy
(enter initial here)