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Give Kids A Smile 2012 - Local project profile

Since 2003, Wisconsin dentists have donated oral health care services to thousands of low-income and underserved children as part of the national Give Kids A Smile day in February.

Register your event with the Wisconsin Dental Association by Jan. 13, 2012 to be included in statewide and regional WDA press releases and eligible for other exclusive offers. Press releases are sent out to more than 600 print, radio, TV and online media contacts.

In honor of the 10th anniversary of GKAS, the first 75 participants to register with the WDA will receive goody bags with a variety of age-appropriate items (floss, toothbrush timers, pencils, toys, etc.).
1.Dental practice name
2.Office address
3.Contact information
4.WDA member name(s)
*please list all participating dentists
5.Project date(s)
6.Project location(s)
7.Please indicate the following:
8.Please briefly describe what you will be doing for GKAS (e.g., classroom presentation, sealants, fluoride rinse or varnish, dental screening/referral program, selected endodontic and surgical services).
9.Any details to share with local media and WDA Journal readers?
10.Are you holding a pre-screening event?
11.Are you scheduling appointments or holding a walk-in event?
12.If we get a call from the public or an organization looking to schedule a child or children for GKAS in your area, may we refer them to your program?
13.Estimated value of services you expect to deliver:
14.Name(s) of cooperating organizations, agencies, co-sponsors:
15.Do you plan to invite your (local,state or national) elected officials
16.If you answered "yes" to the previous item, please name your elected officials:
17.What additional resources can the WDA make available to help you with your event?