Shine Superstar Application

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Lights… camera... action! If you LOVE being in the spotlight and showing off your smile, we have an exciting opportunity for you! We are in search of our very first SHINE SUPERSTARS!

As a Shine Superstar, you’ll get the ultimate VIP experience - starting with a FREE photoshoot! By sharing your photos from your session and participating in social media challenges throughout the year, you’ll get entered to win quarterly prize drawings and the GRAND PRIZE: A $500 SHOPPING SPREE! Other perks of becoming a Shine Superstar include exclusive gifts and Shine swag!

For all the details visit https://www.shineorthostudio.com/shinesuperstars.html.

*Must be a current patient between the ages of 11-18 and able to attend the free professional photo shoot on September 12th to apply. Application deadline is August 31st. Grand prize drawing will take place at the end of the school year.

Are you able to attend the free professional photo shoot day on Sept. 12th from 1-3pm?

Yes

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First Name *

Last Name *

Are you a current Shine Ortho Studio patient? *

Yes

Are you currently in braces? *

Yes

Why do you want become a Shine Superstar? *

How did you hear about the Shine Superstar campaign? *

Cell Phone Number *

Email Address *

Address *

Birthday *

YYYY

What school do you attend? *

What is your Instagram username?

What is your Facebook name?

Please list any other social media accounts and usernames:

What activities are you involved in? *

Shirt Size (Adult Sizes) *

XXL

Other:

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