Registration Package for Academic

Only applicants with a full-time appointment at the University of Manitoba, Dr. Gerald Niznick College of Dentistry, are eligible for registration in the Academic class. The complete requirements for successful registration in this category are available in the  Bylaw for Registration and Licensure of Dentists and this package.

Relevant Forms and Documents

1. Checklist for Registration in the Academic Category
2. Instructional Guide for Completing Dentist Registration Application Form
3. Dentist Initial Registration Application Form
4. Certificate of Standing for other Health Professions and Jurisdictions
5. Consent to Release Regulatory Information Form
6. Consent to Release Third Party Assessment Information Form (NDEB)
7. Consent to Release Third Party Assessment Information Form (RCDC)
8. Declaration and Agreement of Applicant to MDA Academic Category
9. Agreement of Supervisor to Member in Academic Category
10. Consent to Release Health Information Form
11. Declaration of Commitment to Ethical Practice and the Public Interest