Smile Club

Join the amazing Smile Club!

Sponsored by Mrs. Tate, Librarian

Prerequisite: You must have braces, retainer,

or head gear, from here further to be called teeth utensils at time of
application. Complete the form below and return to Mrs. Tate.

First and Last Name: _________________________

Date you got your teeth utensils: ________________
What is the best part of your teeth utensils?
_______________________________________________
_______________________________________________
What is the worst part of your teeth utensils?
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
I give Mrs. Tate permission to post my childs picture and
Smile Club Application on a bulletin board for a book
promotion project. Upon taking down the bulletin board, I am

requesting the photograph and application be returned to me

through my child.
_______________________

______________________

Childs Full Name

Parents Signature

________________________ ______________________
Homeroom/Grade

Date
Book Summary: As Raina goes through
middle school, she accidentally knocks out
her two front teeth! Things get crazy and
dramatic when she has to have fake teeth
and braces and her friends and boys join
the adventure!
Own Smile by Raina Telgemeier today!

Bulletin Board in use!