Orthodontics Externship Program Domestic Application

Please fill out the form below.

Important Dates:

Externship Start Date: April to September (length from 1 day to 10 days).
Applications will be reviewed on a rolling basis.
Email Notification Letters for Acceptance will be sent within 4 weeks after application is received.

Domestic Application Heading link

Applicant Name
First Last
Applicant Email ID * Required
Enter Email Confirm Email
Applicant Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Qualification * Required
Profession * Required
How did you hear about Orthodontics Externship Program? * Required
Preferred Attendance Days * Required
Please note, this is a preference only and we will do our best to honor the request.
Copy of Applicant's Curriculum Vitae * Required
Max. file size: 15 MB.
Copy of Applicant's Dental School Transcript * Required
Max. file size: 15 MB.
Transcript can be official or unofficial
Letter of Recommendation * Required
Max. file size: 15 MB.
A letter of recommendation from a Dental School Faculty or Administrator.
Consent * Required
By clicking this checkbox, I agree to receive notifications about the status of my application or any communication related to my application at UIC College of Dentistry.
Consent
By clicking this checkbox, I agree to receive marketing email and/or notifications about various College events, symposiums, webinars relevant to Dental field at UIC College of Dentistry.
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