NOSW Dental Stipend - New Opportunity School for Women

Thank you for your interest in the NOSW Dental Stipend. This stipend is available exclusively to graduates of the NOSW Berea residential program. Please review the following guidelines and complete the application below.

Important Notes:

The dental stipend may be applied toward the following procedures performed by a licensed provider: dentures, partials, cleaning, fillings, extractions, crowns, gum restructuring, and co-pays.
The stipend does not cover these procedures: teeth whitening, braces, teeth jewelry, or other cosmetic procedures.
The dental stipend is subject to the availability of funds, and there is no guarantee that you will be awarded the full amount requested, or that funds will be available at all.
Before any dental work can be approved or payment issued, NOSW must receive a Care Plan from your dentist that details the proposed treatments and costs.
Once the estimate is received, we will be in touch with the dentist to authorize that NOSW will pay for a specific amount. You will then be notified that you can proceed with the work. The dentist will be paid directly according to the amount authorized by NOSW. Any dental expenses other than the amount authorized will not be covered by NOSW.
You must wait until you receive confirmation of your application approval before undergoing any dental procedures. NOSW will not be responsible for any dental costs incurred before receiving the approval letter, nor for any amount exceeding the stipend amount awarded.
Applications and all required documents must be submitted no later than 1 week after your application has been submitted. If this deadline is not met, you will need to reapply for future consideration.
If you have received the dental funds before, please note that the total amount that will ever be awarded to our graduates is $1260. Once you have received this amount, you will not be awarded any more.

Please direct questions from your dentist to:

Susan Jordison
Operations Manager
The New Opportunity School for Women
204 Chestnut Street
Berea, KY 40403
859-985-7200
sjordison@nosw.org

Dental Stipend Application

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Year you graduated from NOSW:

Name of dental provider:

First Last

Address of dental provider:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone number of dental provider:

Name of contact person at dental office:

First Last

Email of contact person at dental office:

Do you have dental coverage?

Yes

If yes, please tell us what your coverage is:

Have you received assistance from the NOSW Dental Stipend before?

Yes

If yes, when and how much?

What kind of dental work are you seeking? Please provide details.

Please upload the Care Plan from your dentist. If you are unable to upload, you may submit your Care Plan to Susan Jordison at the address above.

Max. file size: 300 MB.

Dental Stipend Application

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