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Note: This contest is open for children living in Alabama either enrolled and attending third grade, or 8 to 10 years of age being home-schooled. Be sure you have read the Official Contest Rules before submitting your photo.
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Student's Name
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Student's Birthdate
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How did you hear about the "Share Your Smile with Alabama" contest?
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Name of School
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Name of Homeroom Teacher
If homeschooled,
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What county do you reside in?
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Legal parent or guardian Name
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Legal parent or guardian email address
Example: janedoe@nowhere.com
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Legal parent or guardian phone number(s)
Format the phone number(s) as follows: 1112221234 no dashes or letters will be accepted in this field.
Is child in foster care?
If yes, the social worker responsible for the child must sign
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