| Page 4 | Temple University Kornberg School of Dentistry

First name *

Last name *

Email address *

Verify Email Address *

Type of Request *

Transfer

Re-Admission

Dental School Matriculation Year *

AADSAS ID number from when you applied *

AADSAS ID number from when accepted to dental school

Which dental school do/did you attend? *

Are you currently enrolled in dental school? *

Yes

No

If not enrolled, which below best describes why *

If not enrolled, please explain.

Credit Hours Completed in Dental School *

Current Cumulative GPA in Dental School *

Anticipated year of transfer/re-admission to Temple *

Undergraduate Major *

Graduate School Major

Leave this field blank

Kornberg School of
Dentistry