You have been approved to enroll in the DentCentive Program! Start earning extra cash now!

1. Download the IRS W-9 fillable form. Complete and Sign this form, then save it to your computer. (NOTE: You must upload this completed file below to enroll in the program. IRS W-9 must be signed by hand, typing your name will not be acceptable.)
2. Complete Enrollment form below.
3. Upload completed IRS W-9 form.
4. Enroll in the DentCentive text balance feature if you would like to receive text alerts following transactions on the card.
5. Draw signature in E-Signature box.
6. Click Submit Form to enroll and receive confirmation.