Please complete the supplemental form as required by selecting the information from below form. Applicant must provide full legal name as it appears on his/her passport. If appropriate, please also provide maiden name in order to match application documents.

Please list your current place of residence if different from mailing address listed on CAAPID application.


All reapplicants must submit a CAAPID application, Penn Dental PASS Supplemental Application, essay responses, and application fee. Documents from prior application (NBDE Part 1 scores, TOEFL scores and letters of evaluation) can be carried forward if they are available from our record archives. Reapplicants must complete questions 1–3 under the Custom Questions section on CAAPID regarding PREVIOUS APPLICATIONS TO US DENTAL SCHOOL. Serious consideration will be given to those with exceptional academic records and credentials. Please note that TOEFL Scores from 2016 and earlier will not be considered.


Please indicate your clinical experience in each of the follow dental disciplines by selecting the appropriate response. You may add any comments to describe your clinical training or experience in these areas on a separate sheet of paper. Please specify only post graduation hands on experience (not observership).

Restorative dentistry:


Restoration of Implants:

Placing of Implants:


Pediatric dentistry:



Oral Surgery:

Oral Medicine:

Diagnosis/treatment planning:

Special needs patients:

Adhesive restorative materials:

CAD-CAM/digital restorative:

Use of loops/microscopes:

Please type your responses to each of the following questions listed below. One-thousand word limit per response, single line space. Please convey your thoughts adequately and concisely.

    * 1. What did you most enjoy in your practice of dentistry?

    * 2. How have your goals changed for clinical practice since coming to the U.S.?

    * 3. Describe (if applicable) your work experience (paid or unpaid) in the U.S. or Canada and how it contributes to your professional experience.

    * 4. What qualities of Penn Dental Medicine do you feel will help you achieve your professional goals and how?


You must submit the following documents to be considered for an interview. For serious consideration, all items should be received a month in advance of the June 1, 2019 deadline. All application materials and documents become the property of the University of Pennsylvania School of Dental Medicine and will not be returned to the applicant.

  • Please submit the Application fee of $75. Electronic payment is available by completing the Penn Dental Medicine payment form.
  • Official National Dental Board Examination (NBDE) Part 1 scores must be submitted electronically to CAAPID Application Service.
  • Official TOEFL scores should be submitted electronically to CAAPID Application Service.
  • Official copy of the ECE Course-by-Course Evaluation Report and G.P.A. must be submitted to the CAAPID Application Service.
  • Three letters of evaluation on official letterhead with signature should be submitted to the CAAPID Application Service.

I hereby certify that I provided accurate information in this application. I understand and agree that any misrepresentation or omission of facts in my application will justify the denial of admission, the cancellation of admission or expulsion. I also understand that all matriculated students are required to undergo a Criminal Record Check and Child Abuse History Clearance in order to treat minor patients in the Commonwealth of Pennsylvania. I also understand that I will be responsible for payment of such fees (approximately $80 - $100).

The University of Pennsylvania values diversity and seeks talented students, faculty and staff from diverse backgrounds. The University of Pennsylvania does not discriminate on the basis of race, color, sex, sexual orientation, gender identity, religion, creed, national or ethnic origin, citizenship status, age, disability, veteran status or any other legally protected class status in the administration of its admissions, financial aid, educational or athletic programs, or other University-administered programs or in its employment practices. Questions or complaints regarding this policy should be directed to the Executive Director of the Office of Affirmative Action and Equal Opportunity Programs, Sansom Place East, 3600 Chestnut Street, Suite 228, Philadelphia, PA 19104-6106; or (215) 898-6993 (Voice). The federal Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act, as amended, requires colleges and universities to provide information related to security policies and procedures and specific statistics for criminal incidents, arrests, and disciplinary referrals to students and employees, and to make the information and statistics available to prospective students and employees upon request. Federal law requires institutions with on-campus housing to share with the campus community an annual fire report. In addition, the Uniform Crime Reporting Act requires Pennsylvania colleges and universities to provide information related to security policies and procedures to students,employees and applicants; to provide certain crime statistics to students and employees, and to make those statistics available to applicants and prospective employees upon request. You may view the report at or request a paper copy of the report by calling the Division of Public Safety’s Special Services Department at 215-898-4481.

If you have any questions regarding the admissions process, contact 215-898-0558 Monday - Friday from 9:00 a.m. through 4:30 p.m. or
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