For information concerning Admissions to Baylor College of Dentistry, print this form and mail to:

Admissions
Baylor College of Dentistry
P.O. Box 660677
Dallas, Texas, USA 75266-0677
admissions-bcd@bcd.tamhsc.edu

The form is also available in Adobe Acrobat format. The Acrobat version may be filled in online before printing from the screen. 
Goto: Request Information Acrobat Form

Admissions Information Request Form

 Date: ____/____/____

Name:

First __________________ Middle __________________ Last __________________
 
Present Address:
 
Street 1 __________________ Street 2 __________________ Bldg/Rm __________________
 
City _______________________________________State ____ Zip/Postal ________________
 
 
State of Residence:  ______________________
 
 
Country: ________________________________
 
 
Phone: ________    _______________________
 
 
Planned Year of Entry: _____________________
 
 
DAT Date:____/____/____
 
 
High School: ____________________________  Grad Year: ____________
 
 
College:     ____________________________   Grad Year: ___________
 
 
 
Career Interest:  _______ Dental   _______ Hygiene _______ Both
 
Spoke to a Health Professions Advisor: _____ Yes _____ No
 
Sex: _____ Male  _____ Female (Optional)
 
 
Race or Ethnic Group:(Optional)
 
____ Am. Indian          ____ Alaskan Native       ____ Black
 
____ Asian                ____ Hispanic                ____ White