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1. Personal Information
(Please complete the following information)
Student First Name: * M.I.:
Student Last Name: * Suffix (Jr.,etc.):
Student Person Number
or Social Security
Number: *
Student Gender: *
Student Birthdate:
(use 4-digit year) * Month: Day: Year:
Phone Number: *
Your E-Mail: * (for e-mail receipt)
Apply to Semester: *
DENTPIN (use 8-digit number): *
* - Required
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2. Verify Payment Selection
(Please verify that this is the correct payment item.)
IDP Application Fee ($75.00)
International Dentist Program Application Fee
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3. Proceed to Payment
Credit Cards / eChecks Accepted
UB currently accepts eChecks, Visa, MasterCard, and Discover.
Debit Cards with Visa or MasterCard logos are accepted.
Daily limits on these cards vary, please contact your bank.
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