St. John's University
DeltaCare USA Dental Plan
2024-2025 Policy Year Enrollment Form

The enrollment deadline for coverage effective September 1, 2024 through August 31, 2025 is August 15, 2024.

PLEASE FILL OUT THE REQUIRED FIELDS BELOW TO CONTINUE THE ENROLLMENT PROCESS:

INTERNATIONAL STUDENTS: If you do not have a social security number, please use your visa number in the "social security number" field below. If your visa number contains a letter, replace each letter with a "9". Additionally, because a social security number is 9-digits long, please use more "9"s at the start of your visa number if it is not long enough to fill the "social security number" field.