Help Minnesota Smile Survey

Name*

First Last

Organization*

Title at Organization*

Email*

Phone

Link to your organization's logo

Please select your preferred participation level:*

Supporter
Partner

A SUPPORTER:
- Have your logo and name on the HelpMNSmile website
- Organization included on consensus letter sent to Governor and Legislators
- Participate in a social media push on a date TBD

A PARTNER:
- Have your logo and name on the HelpMNSmile website
- Organization included on consensus letter sent to Governor and Legislators
- Participate in a social media push on a date TBD
- Participate in media opportunities
- Provide support during the legislative session