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From Our Hearts to Your Smile

How to apply for our Smiles from the Heart program:

1
Download Application

Download and complete our PDF application.

2
Submit Application

Send us your application and other details with the form below. We accept PDF and JPG files.

3
Get Results

We’ll let you know about our decision within 6 weeks of receiving your application.

Submit your Application

Complete all fields via the form below. We accept JPG and PDF files. All fields are required.

Upload PDF or JPG of the completed Smiles from the Heart application.
Accepted file types: pdf, jpg, Max. file size: 50 MB.
Upload PDF or JPG of the essay as described in the Smiles from the Heart application.
Drop files here or
Accepted file types: pdf, jpg, Max. file size: 50 MB.
    Upload 2 close-up photos of the applicant when smiling.
    Drop files here or
    Accepted file types: jpg, jpeg, png, gif, Max. file size: 50 MB, Max. files: 2.
      Most recent federal tax return (1040, 1040a or 1040ez). You can also bring your tax return to your home clinic for consideration.
      Drop files here or
      Max. file size: 50 MB.

        Please understand that we receive many applications for this program and completing an application does not guarantee acceptance. Recipients are chosen based on a variety of factors. Smiles From The Heart applications are reviewed quarterly, and Parents/Guardians are notified directly.