Please enter your Social Security Number (no dashes or spaces).
Your SSN must be a nine-digit number. Alpha characters are not accepted.
If you do not have a Social Security Number, you may use one of the following forms of ID:
  • Tax I.D.
  • Passport
  • Visa
  • Work Permit
  • Canadian Social Insurance Number
Please indicate the country of origin for the alternative ID. Do not enter all zeroes (000000000) or your application will be incomplete.
Please note that the ID number will be needed to process your application registration.
This photo will be used for your identification badge at the exam so it should present you in a professional manner. The photo must be a recent (taken within six months), passport quality, head and shoulders picture of you.
When taking the picture, it is recommended that you stand in front of a solid, light-colored background. Pictures that are unacceptable include indistinct pictures, group pictures, full body pictures and pictures that are too close, failing to show the candidate’s head and shoulders. Pictures showing any school affiliation will be rejected.


Please select your Dental school and month/year of graduation.

Please select your Dental Hygiene school and month/year of graduation.

If you have completed or are registered in a Local Anesthesia course, enter your Local Anesthesia school and course completing month/year. You will not be able to register for a Local Anesthesia exam until you have entered your school information.

If you have completed a Restorative course, enter your Restorative school and course completion month/year. You will not be able to register for a Restorative exam until you have entered your school information.