Note: The program is closed to new applications

Your application will consist of a three-step process:

Step 1. Eligibility Screening (Due on or before November 3, 2017)

Individuals interested in applying should submit all information requested on the online form.

Step 2. Background and Credit Check Screening

Individuals that successfully pass the basic eligibility screening will be sent a Consent for Background and Credit Check form. When received, Delta Dental of Minnesota Foundation will then complete a Background and Credit Check screen to further determine eligibility.

Step 3. Full Application (Due on or before December 30, 2017)

All individuals will be contacted regarding their eligibility, and those deemed to meet the eligibility requirements will be invited to submit a full application online. The following information must be submitted as part of the application:

  1. One original set of official transcripts from all dental and graduate schools attended (mailing directions below)
  2. Applicant’s current resume
  3. Proof of licensure or a brief explanation of the Applicant’s plans for obtaining licensure
  4. Documentation of any outstanding qualified education loan debt
  5. Applicant’s written statement* of no more than three single-spaced pages
  6. Description of Applicant’s proposed practice setting (owner, associate to buy, etc.)
  7. Written acknowledgement from the Applicant’s employer or practice owner that, if selected, they will support the applicant to meet the program requirements (if applicable)
  8. Brief business plan for Applicant’s proposed dental practice and its feasibility (if applicable)
  9. At least one letter of support from someone other than the Applicant’s proposed employer or practice owner
  10. Disclosure of any other education loan repayment or forgiveness received or approved to be received by Applicant
  11. Disclosure of any relationship to Delta Dental of Minnesota Foundation, Minnesota Dental Foundation, or any potential conflicts of interest of the Applicant
  12. Disclosure of any issues related to academic, clinical and or code of conduct that resulted in a formal sanction by the applicant’s dental school, and or the university
  13. Overall class rank
  14. Additional documents, letters, or exhibits that support the application

*The written statement should include a description of the following:

  • Why you are interested in practicing dentistry in a designated, rural HPSA and/or priority area of the DMD Program in Minnesota
  • Your experience and commitment to serving underserved populations
  • A description of the community’s oral health needs and opportunities
  • Your community and volunteer experience
  • Your immediate and long-term professional goals
  • Any community matching funds, economic development funds, or relocation assistance you are planning to receive


Submit an original copy of transcripts via email to or by mail to:

Delta Dental of Minnesota Foundation
Attn: Annessa Hicks, Program Associate

500 Washington Ave. S, Ste. 2060 Minneapolis, MN 55415