NDSE Exam Application

Account Information

Please confirm your basic information before continuing.

First Name*

Middle Name

Last Name*

Email Address*

Gender*

Date of Birth*

Billing Address

Please enter a complete and valid billing address.

Street Address*

City*

Province*

Postal Code*

Country*

Language of Communication*

Mobile phone

Country Phone Number

Work phone

Country Phone Number

Home phone

Country Phone Number

NDSE Application

Thank you for confirming your account information. All fields are required unless marked optional. Once your application is submitted it can only be changed by RCDC staff.

Section 1: Examination Details

Examination Specialty*

Examination Language*

Supporting Documents*

Have you submitted supporting documents to RCDC for a previous examination application in this same specialty?

Self Disclosure Declaration*

Preferred Test Centre*

Please be aware that the chosen test centre might change due to capacity constraints.

Preferred city for consideration*

Your preferred city is not listed. Please provide it for consideration.

Government-Issued Photo Identification*

Accepted file types: pdf, jpg, jpeg, png, Max. file size: 5 MB.

Please upload a copy of the ID you will use to identify yourself on examination day (Health Card not accepted). Your ID must be valid up to the day of the examination.

Section 2: Emergency Contact

Emergency Contact Name (Optional)

Emergency Contact Email (Optional)

Emergency Contact Phone Number (Optional)

Country Phone Number

Section 3: Dental Specialty Training Program

Specialty Training Program Name*

Training Program Status*

University Name*

University City*

University State*

University Country*

Specialty Training Program Start Date*

Specialty Training Program End Date*

If your program is in progress, enter the expected end date.

Section 4: Examination Accommodations

Do you have any examination accommodation requirements?*

Please list the reason(s) for the requested accommodation*

Please provide further details*

Please list the accommodation(s) that you are requesting below*

Supporting documentation*

Drop files here or

Accepted file types: pdf, jpg, jpeg, png, Max. file size: 5 MB, Max. files: 1.

Please attach any supporting documentation as part of your request. Enclosures must support the reason(s) for accommodation given above. Accepted formats: PDF, JPG, PNG.

I hereby certify to the best of my information, knowledge and belief that all information provided in this form, as well as any attachments, is accurate.*

I agree

Section 5: NDSE Certification Registry

Consent to be included in the NDSE Certification registry*

Consent: I hereby consent to be added to the NDSE Certification registry. Do Not Consent: I DO NOT consent to be added to the NDSE Certification registry.

National Dental Specialty Examination (NDSE)

Payment for all applicable fees is required to complete an application to challenge the NDSE.

To complete your payment:

Enter your payment information
Select “Submit order”

YOUR EXAMINATION APPLICATION WILL NOT BE SAVED UNTIL YOU CLICK “SUBMIT ORDER”

NDSE Application Fee

$750.00

NDSE Examination Fee

$3,075.00

Payment Method*

Credit Card (Stripe)

Cheque

Interac e-Transfer

Credit Card

NDSE Exam Application

NDSE Exam Application

Account Information

Billing Address

NDSE Application

Section 1: Examination Details

Section 2: Emergency Contact

Section 3: Dental Specialty Training Program

Section 4: Examination Accommodations

Section 5: NDSE Certification Registry

National Dental Specialty Examination (NDSE)

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