Fall 20 Application - California State University, Sacramento 2026

1. Click ‘Get Form’ to open the Fall 20 Application in the editor.
2. Begin with SECTION A – PERSONAL INFORMATION. Fill in your legal name, maiden name, mailing address, date of birth, and contact details. Ensure accuracy as this information is public.
3. Proceed to SECTION B – Office Address. Enter the address where moderate sedation will be administered. Remember that separate permits are needed for each location.
4. In SECTION C – LICENSURE INFORMATION, provide details about any dental licenses you hold or have held. Request direct verification from each state if necessary.
5. Complete SECTION D – CONVICTION AND LICENSURE INFORMATION by answering all questions truthfully and providing documentation for any affirmative responses.
6. Continue through the remaining sections (E-H), ensuring you attach any required documents such as proof of education and certifications.
7. Once all sections are filled out, review your application for completeness before submitting it online or mailing it to the provided address.

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