St. John's University
DeltaCare USA Dental Plan
2026-2027 Policy Year Enrollment Form

The enrollment deadline for coverage effective September 1, 2026 is August 15, 2026.

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.