Download MATCH Form - Indiana University School of Dentistry

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Indiana University School of Dentistry
1121 W Michigan Street
Indianapolis, IN 46202
Please complete this form and return to:
Indiana University School of Dentistry
Office of Graduate Education
1121 W Michigan Street, Room 280B
Indianapolis, IN 46202
If you wish, you may send completed form electronically to [email protected]
The faculty in the Indiana University School of Dentistry, Department of Orthodontics feel that residency
program participation in the Postdoctoral Dental Matching Program is fair and beneficial to
applicants. We also believe that Match participation is in the long-term best interest of the orthodontic
specialty. Therefore, we have decided to interview applicants who are applying exclusively to programs
participating in the Match. Please answer the following question regarding your program application
intentions.
Are you applying exclusively to programs participating in the Match? Yes No
____________________________________
Printed Name
____________________________________
Signature
___________________________
Date
This form must be completed and returned in order to be considered for an interview at Indiana
University School of Dentistry.
Thank you.