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| |Dental Education Program for Grades K-3 |

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| |A Public Service of the Delta Dental of Oklahoma Charitable Foundation |

|CAPTAIN SUPERTOOTH PROGRAM |SELECTION GUIDELINES & CRITERIA: |

|For ten years Captain Supertooth (CST) has crusaded across |Region. We attempt to fairly distribute CST appearances throughout the state.|

|Oklahoma extolling the virtues of good dental self-care. Using a|That means there may be waiting lists in some regions and not in others. |

|giant toothbrush, fun props, and volunteers from the audience, |Special or At-Risk Populations. Within each region, half of the CST |

|the Captain presents a lively 30-minute program inspiring kids |appearances will be at schools or events with underserved, at-risk, or |

|to be superheroes to their teeth! |special populations (such as foster or disabled children). |

| |First Appearance. Preference is given to schools where CST has not previously|

|Funded entirely by the Delta Dental of Oklahoma Charitable |visited. However, CST will make repeat visits to schools on a non-consecutive|

|Foundation, the program is provided free of charge to schools. |basis. |

|Participating children receive complimentary toothbrushes and |Efficiency. When a school in an outlying area is booked, other schools in |

|brush charts. |that vicinity may be scheduled to maximize the cost-effectiveness of the |

| |Captain’s trip. |

|The Captain Supertooth Program is for all Oklahoma students in |Educational Value. While “working the crowd” at health fairs is fun and |

|kindergarten through third grade. The Captain wishes he could go|entertaining, preference is given to events where the Captain can perform his|

|to every school every year. Although we now have four Captains |30-minute educational presentation. |

|on the road, our resources are limited. We appreciate your |Nonprofit Events. Captain Supertooth is primarily intended for Oklahoma |

|understanding as we try to reach as many Oklahoma kids as |schools. However, if resources allow he may be booked for health-focused |

|possible! |special events (such as health fairs) sponsored by non-profit organizations. |

| |The Captain cannot be booked by preschools, daycares, or businesses. (See a |

| |list of resources for daycares and preschools on our website at |

| |.) |

To request a Captain Supertooth appearance at your school or event, please complete the Captain Supertooth Request Form (page 3-4).

Request forms must be submitted by each school for each event.

|[pic] |For assistance please contact: |

| |Terrisa Singleton, Charitable Foundation Specialist |

| |Phone: 405-607-4788 or 800-522-0188 x 788 |

| |E-mail: captainsupertooth@ |

|[pic] |FREQUENTLY ASKED QUESTIONS |

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1. What does it cost to have Captain Supertooth come to my school?

Captain Supertooth is a program of the Delta Dental of Oklahoma Charitable Foundation and is provided to schools and nonprofits free of charge. Each student receives a free toothbrush and brush chart with instructions for proper brushing and flossing and a message to parents.

2. When are Captain Supertooth visits available?

In 2000, the Delta Dental of Oklahoma Charitable Foundation launched the Captain Supertooth program as part of National Children’s Health Month, annually observed in February. Today, the program is available throughout the school year.

3. How do I request a Captain Supertooth visit?

The process starts with the Request Form. Go to to download the Request Form. We prefer that you e-mail the completed form to us, but we will accept faxed request forms as well.

4. If we turn in a Request Form are we guaranteed a visit?

The Captain wishes he could go to every school every year. Although we now have four Captains on the road, our resources are limited. Please see the Captain Supertooth flyer for selection criteria and guidelines. We appreciate your understanding as we try to reach as many Oklahoma kids as possible!

5. Why is the program limited to kindergarten through 3rd grade students?

The Captain’s presentation is designed to effectively communicate oral health basics to children ages 5-8. The boisterous character can actually frighten Pre-K students, and students beyond 3rd grade tend to be “too cool” for a costumed superhero! (See list of resources for preschools and daycares on our website.)

6. How many students can participate?

The ideal setting is a group of 75-100 students in a cafeteria or gym. Visits to individual classes are an option, but a larger venue tends to make a stronger impact on the students in addition to being more fun! Presentations to groups exceeding 100 students are possible but require a microphone and sound system. Single or multiple performances are available, depending on the venue size and school schedule. The Captain Supertooth Coordinator will work with you to devise the best possible program for your students.

7. How long does it take?

The presentation lasts 25-35 minutes depending on the crowd size and interaction.

8. What does the school need to provide?

• Presentation venue (cafeteria, gym, classroom)

• Private changing room or enclosed area located close to the performance space where the Captain can change into his/her costume. (Cannot be student restroom but can be faculty restroom.)

• Scheduling Contact - This is the person who will work with our Captain Supertooth Coordinator to plan your program. It’s very important for this person to be available by e-mail.

• Onsite Coordinator - This is the person the Captain will check-in with upon arrival. This person will assist the Captain with child supervision at the performance site.

• A table to set up in the performance space for use during the presentation (card table or 6 ft table, etc.)

• An electrical outlet to plug in the Captain’s musical accompaniment.

• A glass or bottle of water to quench the Captain’s superhero thirst.

9. Who do I contact with questions?

Please submit the Request Form first. Submit any booking-related questions along with your form. For other questions, contact Terrisa Singleton at 405-607-4788 or 800-522-0188 ext. 788 or e-mail us at captainsupertooth@.

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|CAPTAIN SUPERTOOTH REQUEST FORM |

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|Instructions: |

|IMPORTANT: Save this file to your computer’s hard drive before you begin completing it. |

|Type answers in right column. Save file. |

|E-mail completed form as an attachment to: captainsupertooth@ |

|If necessary, you can fax form to: 405-607-4768 (E-mail preferred.) |

|We will contact you soon regarding scheduling a visit. Please keep in mind there are waiting lists in some regions. |

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|School Information |

|Date Submitted | |

|School (or Organization) | |

|School’s physical address | |

|City | |

|ZIP Code | |

|County | |

|Complete mailing address (if different) | |

|Phone number | |

|Web site address | |

|School district | |

|We are requesting presentation(s) for: |[ ]K [ ]1st grade [ ]2nd grade [ ]3rd grade |

|(Place an X by all that apply) | |

|Number of K-3 students: |Grade |

| |# of Students |

|(Only list number of students in grade(s) you are | |

|requesting presentations for.) |K |

| | |

| | |

| |1st |

| | |

| | |

| |2nd |

| | |

| | |

| |3rd |

| | |

| | |

|Place an X next to all that apply: |[ ] Title I School |

| |[ ] More than 50% of school’s students qualify for free/reduced lunch program. |

|TYPE OF REQUEST: |[ ] School Performance |

| |[ ] Special Event Appearance (Health Fair, etc.) |

|IF SCHOOL PERFORMANCE | |

|List 3 dates, weeks, or months in order of preference (if| |

|any): | |

|IF EVENT (must be health-focused) | |

|Describe event, including date, time, purpose, and number | |

|of K-3rd graders expected to attend: | |

|VENUE (school cafeteria, gym, etc.) | |

|Where should Captain Supertooth park? | |

|What door should he enter? | |

|Where should he check in? | |

|Has the Captain visited your school/event in the past? If | |

|so, when? | |

|Contact Information *Designates required information. |

|SCHEDULING CONTACT | |

|Name* | |

|Title/position* | |

|Daytime phone* | |

|Cell phone* | |

|Email address* | |

|ONSITE COORDINATOR | |

|Name* | |

|Title/position* | |

|Daytime phone* | |

|Cell phone* | |

|Email address* | |

|SCHOOL PRINCIPAL | |

|Name* | |

|SCHOOL NURSE | |

|Name | |

|Phone number and/or email address | |

|OTHER USEFUL CONTACTS | |

|(Include titles and contact information.) | |

|Requirements |

|Captain Supertooth's needs are few and simple, yet very important. |

|Please plan to provide the following: |

|A private changing room or enclosed area located close to the performance space where the Captain can change into his or her costume. (Cannot be student |

|restroom but can be a faculty-only restroom.) |

|An Onsite Coordinator: This is the person the Captain will check-in with upon arrival. This person will assist the Captain with child supervision at the |

|performance site. In the case of health fair/events, this would include herding younger audiences into the performance viewing area and moving older children |

|onto other activities. |

|A table set up in the performance space for use during the presentation (card table, 6' banquet table, etc.). |

|An electrical outlet to plug in the Captain's musical accompaniment. |

|A glass or bottle of water to quench the Captain's superhero thirst. |

Feel free to list any additional information about your school or event:

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