3702.89 Application for participation in the dentist loan repayment program.

(A) An individual who is not receiving national health service corps tuition or student loan repayment assistance and meets one of the following requirements may apply for participation in the dentist loan repayment program:

(1) The applicant is a dental student enrolled in the final year of dental college.

(2) The applicant is a dental resident in the final year of residency.

(3) The applicant has been engaged in the practice of dentistry for not more than three years prior to submitting the application.

(B) An application for participation in the dentist loan repayment program shall be submitted to the director of health on a form the director shall prescribe. The following information shall be included or supplied:

(1) The applicant’s name, permanent address or address at which the applicant is currently residing if different from the permanent address, and telephone number;

(2) The dental college the applicant is attending or attended, dates of attendance, and verification of attendance;

(3) If the applicant is a dental resident, the facility or institution at which the dental residency is being performed;

(4) A summary and verification of the educational expenses for which the applicant seeks reimbursement under the program;

(5) If the applicant is a dentist, verification of the applicant’s license issued under Chapter 4715. of the Revised Code to practice dentistry and proof of good standing;

(6) Verification of the applicant’s United States citizenship or status as a legal alien.

Effective Date: 10-29-2003; 09-05-2006