Application for Dentist Loan Repayment For Service Program 

Follow these tips to ensure that completing and submitting this online application goes smoothly.

1. Prepare in advance. This application requires detailed information, narrative responses, and multiple file uploads.
   
   
2. The form must be completed in one sitting. If you exit the page before submitting the form, your information will not be saved.
   
   
3. The entire form is displayed below.  We suggest you prepare all materials and answers before beginning the online application form.
   
   
4. Answer the 'expressions of interest' thoughtfully. Your responses to the four essay questions will weigh heavily in the Board's approval decision.

Also note:

• Priority will be given to those applicants who indicate that their practice location will be in an area identified as a critical need area by Delta Dental.
  
  
• Required responses are marked with an *
  
  
• Applications are due by November 1. Approval decisions will be made by December 15, and first payments made in Q1 of the following new year.

Contact Connie Halverson, Vice President of Public Benefit, at connie.halverson@deltadentalsd.com or 605-224-7345 if you have any questions about the application process.