Join Us

Thank you for becoming a member of HEALTHY SMILES COALITION. Please fill in the appropriate information below:

1. Registering as a member confirms membership in HEALTHY SMILES COALITION, the official coalition of local citizens, businesses and groups organized to require community water fluoridation in Oregon.

2. Registering does not obligate you to contribute time or money, or attend any meetings or make any public statements. Members are welcome to become involved in coalition activities. However, any further involvement beyond being listed as a supporter of legislation that would require community water fluoridation of Oregon community water systems serving 10,000 or more is entirely voluntary.

3. To show the breadth of our membership, lists of our members may be used on our web site and in materials such as fact sheets, brochures and possibly in advertisements. All statements in such materials will be based on verifiable facts and information, and all publications and activities of our coalition will be conducted in strict compliance with all relevant state and local laws and regulations.

4. All lists of members will note that any titles and affiliations are for identification purposes only.

5. Member contact information will be used solely for communications between HEALTHY SMILES COALITION and our members. Member addresses and other contact information will not be sold or provided to any other groups, organizations or businesses.

6. After registering online, HEALTHY SMILES COALITION will email you within 48 hours to seek confirmation of your registration. Simply replying to that email will confirm your registration.

Business/Organization name:
(If your business or organization is supporting comunity water fluoridation)
First Name: Last Name:
email: Phone number:
Street Address:    
City:: State:
Zip:
Comments: