International Dental Student Exchange Program Application

Applicant Infomration

Please select or type in your date of birth (MM/DD/YY)

Please provide full mailing address


University Information

Required Format for Telephone Number

+ sign followed by the country code, area code, and local number

Required Format for Telephone Number

+ sign followed by the country code, area code, and local number


Emergency Contact Person Information

Required Format for Telephone Number

+ sign followed by the country code, area code, and local number

Required Format for Telephone Number

+ sign followed by the country code, area code, and local number


Arrival/Departure Date


Additional Information

Application Upload Requirements

Upload the following items:

  1. Photo of Applicant
  2. In Good Standing Form
Drag and drop files here or

Download a copy of the In Good Standings Form.


Please note if you do not upload a signed form your application will be returned and may delay your approval.