SMILE-A-THON ENTRY FORM "Printable"



Name:                                     Email: 
Address:                                     Phone:
City:              
State:       
*Age:       

*If you are under the age of 18, then please include your parent's name below.
Parent's Name/Permission:

Yes, I've read & I agree to the contest rules & conditions.


PLEASE CHOOSE BELOW THE CATEGORY THAT YOU WOULD LIKE TO ENTER INTO:

Select only one
Most Beautiful Smile(female)
Most Handsome Smile(male)


ENTRY FEE AMOUNT:

$20 = Entry fee(selected from above)

Please select your total entry fee amount:



METHOD OF PAYMENT: Please select the method of payment that you choose to pay by:

Money order Check



STOP!!


PLEASE MAKE SURE THAT YOU'VE DONE THE FOLLOWING, BEFORE SENDING:


Step 1: Read the contest rules and agree to its terms & conditions(check box in section 1, above).
Step 2: PRINT, then fill out entry form completely & mail it to the address below.
Step 3: Pay & Send the entry fee amount of $20.00 by mail(money order/check).
Step 4: Send a picture of your smile by mail.
Step 5: Be sure all of the items above are sent together with your contact information by
           November 30, 2005.


SEND EVERYTHING TO:

Generation Xcellence
Smile-A-Thon Contest
859 Hollywood Way #148
Burbank, CA 91505