Give Kids A Smile
Give Kids A Smile
Give Kids A Smile
Give Kids A Smile
Clinic October 28 & 29, 2016

If you signed up before October 2010 you may call to register for the upcoming clinic.
Call 636-39Smile (636-397-6453)!

St. Louis, MO - Give Kids A Smile - Event Form

Personal Information
This section does not apply to me.
Dental Office or Organization Information
I am a returning volunteer

Volunteer Information
  1. Clinic Set Up
  2. Clinic Break Down
  3. Clinic Participation
  4. SELECT A POSITION: (3 hours of continuing education credits will be issued per each full day of participation)
  5. Position

  6. DOCTORS: Please bring your own Dental Assistant if possible. (Each volunteer will need to sign up individually)
  7. Please fill-in all your information below that applies:
  8. Any information that would help assign you in our clinic
Please be aware that you are volunteering for a Give Kids A Smile clinic at St. Louis University in Missouri.
Greater St. Louis Dental Society
Delta Dental
ADA - American Dental Association
Missouri Foundation for Health
Click to verify BBB accreditation and to see a BBB report for Give Kids a Smile
Visit for the national Give Kids A Smile program.