NATIONAL DENTAL ASSISTING EXAMINING BOARD BUREAU NATIONAL D’EXAMEN D’ASSISTANCE DENTAIRE 204 - 2283 St. Laurent Blvd, Ottawa, Ontario K1G 5A2 Tel/Tél.: (613) 526-3424 • Fax/Téléc.: (613) 526-5560 • [email protected] Reason for change: □ Marriage □ Divorce □ Other Documents to support request: □ Copy of marriage license □ Copy of Divorce Documents □ Copy of court order □ Other Signature: _________________________________ Date: ____________________ Please Note: If your supporting documents have not been issued in Canada you must then provide a certified true copy, notarized in Canada by a Lawyer, Notary Public or Commissioner of Oaths, translated to English. Fee and Payment: $50.00 CAD *The fee includes a reissuance of a paper copy certificate and a digital certificate. This is subject to change, in the future, at the discretion of the NDAEB. Payment notes: The NDAEB accepts bank drafts, or money orders. The NDAEB does not accept personal cheques or credit card payment. DO NOT SEND CASH
RkJQdWJsaXNoZXIy MzA1NjE=