Street address (Smile Kits will ship here):*
Your school must have a physical presence in the state of Kansas.
ORAL HEALTH EDUCATION/OUTREACH COMPONENT INFORMATION
Describe the oral health education/outreach component of your project/program:*
Does your project/program target uninsured or underserved students in Kansas? If yes, please explain:
How did you hear about the Smile Kit program?*
SMILE KIT REQUEST
The total number of Smile Kits requested must be in increments of 50. The minimum amount of kits you can select is 50 per toothbrush size. In order to meet the minimum order we suggest collaboration among teachers/grade levels.