First Name (required)
Last Name (required)
Address 1 (required)
Zip/Postal Code (required)
Your Email (required)
Your Email 2
Birth Date (required)
Gender as shown on travel document Choose One:MaleFemale
School Name (if applicable)
Current School Year (if applicable)
Do you speak any languages besides English? (Indicate level of fluency)
There will be times when you will be asked to wear an Alliance for Smiles t-shirt or polo shirt that will identify you as a team member.
Shirt Size (in unisex size)
Please describe your current health, including any medical conditions we should be aware of.
Relationship to Applicant
The following documents must be submitted before you can be approved:
Upload Documents Here: www.dropbox.com/request/vXRTqLbm7NIfQfVL1xKR
Once you have completed the application and uploaded all files that you wish to, please agree to the terms and hit the SUBMIT button below.
I fully understand that any significant misstatement in or omissions from this application will constitute cause for denial of my application for affiliation with Alliance for Smiles. I hereby affirm that the information I have furnished to Alliance for Smiles on this application and in any accompanying document is true and complete to the best of my knowledge.
Do you agree to the above terms?