Who We Are Our Mission Who Qualifies How to Apply
Who We Are Smile for a Lifetime Foundation is a charitable, non-profit organization that provides orthodontic care to individuals who may not otherwise have the opportunity to acquire assistance. Smile for a Lifetime Foundation, Lancaster County Chapter aims to award orthodontic braces and treatments to middle school and high school age children who meet an established financial criteria, and who have a support system to help maintain a two year treatment plan.
Our Mission At Smile for a Lifetime Foundation it is our mission to create self confidence, inspire hope, and change the lives of children in our community in a dramatic way. The gift of a smile can do all this for a deserving, underserved individual who in turn, can use this gift to better themselves and our community.
Who Qualifies The foundation has a board of directors who will meet quarterly to review all applications of those candidates who have met all of the requirements of the Smile for a Lifetime Lancaster County Chapter. They will vote and submit all of the potential award winners to be screened by Albright & Thiry Orthodontics. The Doctors at Albright & Thiry Orthodontics do not select the candidates. They act as advisors to the board to aid in any orthodontic questions they may have. When all candidates for that quarter have been screened, the board will then vote again to select the award winners.
How to Apply Please fill out the application below and mail it to the address provided. All potential award winners must include with their application a 5x7 head shot showing their smile and two letters of reference from an adult expressing the reasons they feel the candidate is deserving of such a lifechanging award.
Letters and photos will not be returned. You are not eligible for consideration if you have not met the criteria or have an incomplete application. You will be notified and can resubmit your application for future consideration.
You must submit a 5 X 7 head-shot photo of applicant with full smile and teeth showing. You must have two letters of reference (typed and limit each to one page each).
• •
The applicant is an excellent candidate for Smile for a Lifetime because (please limit answer to space provided):
________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Number of times applicant has submitted an application to Smile for a Lifetime ______ Applicant grade:
______
Applicant’s age:
______
Applicant’s sex: _____
Household income: ________________________________________________________________________________ # of members in household:
Parent/guardian place of employment:
________________________________________________________________________________________
Is applicant covered by dental insurance? __________
If yes, specify company and policy #: ___________________________________________
Contact information: Applicant Name:
________________________________________________________________________________________________________
Parents’ Name:
________________________________________________________________________________________________________
Address:
________________________________________________________________________________________________________ ________________________________________________________________________________________________________
School Name:
________________________________________________________________________________________________________
Parent/guardian/applicant e-mail address: _____________________________________________________________________________________ Responsible party phone numbers: Submitted by (circle one): Self
Home: Parent
______________________ School Nurse
Cell:
School Counselor
_______________________________________________ Dentist
Other_________________________________
Please mail completed form with picture and reference letters to: Smile for a Lifetime Foundation Lancaster County Chapter Attn: Stacey 1834 Oregon Pike Lancaster PA, 17601 Questions: e-mail to [email protected]
Candidates chosen for screening will be asked to provide verification of family income which may include a copy of last year’s tax return, W-2, or a copy of the most recent pay stubs insuring Smile for a Lifetime that financial requirements are met. All applications, pictures and supporting documents will not be returned and become property of Smile for a Lifetime foundation.
Our Mission At Smile for a Lifetime Foundation it is our mission to create self confidence, inspire hope, and change the lives of children in our community in a dramatic way. The gift of a smile can do all this for a deserving, underserved individual who in turn, can use this gift to better themselves and our community.
Who Qualifies The foundation has a board of directors who will meet quarterly to review all applications of those candidates who have met all of the requirements of the Smile for a Lifetime Lancaster County Chapter. They will vote and submit all of the potential award winners to be screened by Albright & Thiry Orthodontics. The Doctors at Albright & Thiry Orthodontics do not select the candidates. They act as advisors to the board to aid in any orthodontic questions they may have. When all candidates for that quarter have been screened, the board will then vote again to select the award winners.
How to Apply Please fill out the application below and mail it to the address provided. All potential award winners must include with their application a 5x7 head shot showing their smile and two letters of reference from an adult expressing the reasons they feel the candidate is deserving of such a lifechanging award.
Letters and photos will not be returned. You are not eligible for consideration if you have not met the criteria or have an incomplete application. You will be notified and can resubmit your application for future consideration.
You must submit a 5 X 7 head-shot photo of applicant with full smile and teeth showing. You must have two letters of reference (typed and limit each to one page each).
• •
The applicant is an excellent candidate for Smile for a Lifetime because (please limit answer to space provided):
________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Number of times applicant has submitted an application to Smile for a Lifetime ______ Applicant grade:
______
Applicant’s age:
______
Applicant’s sex: _____
Household income: ________________________________________________________________________________ # of members in household:
Parent/guardian place of employment:
________________________________________________________________________________________
Is applicant covered by dental insurance? __________
If yes, specify company and policy #: ___________________________________________
Contact information: Applicant Name:
________________________________________________________________________________________________________
Parents’ Name:
________________________________________________________________________________________________________
Address:
________________________________________________________________________________________________________ ________________________________________________________________________________________________________
School Name:
________________________________________________________________________________________________________
Parent/guardian/applicant e-mail address: _____________________________________________________________________________________ Responsible party phone numbers: Submitted by (circle one): Self
Home: Parent
______________________ School Nurse
Cell:
School Counselor
_______________________________________________ Dentist
Other_________________________________
Please mail completed form with picture and reference letters to: Smile for a Lifetime Foundation Lancaster County Chapter Attn: Stacey 1834 Oregon Pike Lancaster PA, 17601 Questions: e-mail to [email protected]
Candidates chosen for screening will be asked to provide verification of family income which may include a copy of last year’s tax return, W-2, or a copy of the most recent pay stubs insuring Smile for a Lifetime that financial requirements are met. All applications, pictures and supporting documents will not be returned and become property of Smile for a Lifetime foundation.
