By telling us your story, we’ll be able to share with others in our community how A Gift Of Smiles has made a difference. "*" indicates required fields Name* First Last Email* Phone*I prefer to be contacted by* Email Phone May we leave a voicemail?* Yes No How has your involvement with A Gift Of Smiles benefited you, a loved one or your community in terms of increasing quality of life or satisfaction?*Would you be willing to share your story on our website? If we edit your story, you will have final approval prior to publication* Yes, I give AGOS permission to share it with volunteers, staff and the community (we will only identify your first name and last initial) I wish my identity to remain anonymous, but I give AGOS permission to share it with volunteers, staff and the community No thank you Occasionally we are approached by local news media or we promote the work of A Gift Of Smiles foundation during our fund raising events. Would you be interested in sharing your story in a brief interview?* Yes No Consent* If I agree to publication of my story, I agree to the privacy policy.I grant A Gift Of Smiles, its agents or the news media the right to photograph and/or take videography of me and to use the photographs/videography for publicity and news purposes. I also grant A Gift Of Smiles, its agents and the news media the right to record my voice and/or use my comment(s). These photographs, videography, my voice and/or comment(s) can be used for promotional purposes including but not limited to A Gift Of Smiles Web sites, social media outlets, digital advertising, television and radio platforms, online and print publications, and through news outlets for media use. I warrant that the rights granted herein do not conflict with any existing commitments on my part. Δ
