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Thank you for your interest in The CariFree Cooperative!

If you have not yet taken the video course, please click here to do so before completing the below application.

The CariFree Cooperative Application

CONTACT INFORMATION
First and Last Name*
Address*
Phone Number*
Email Address*
Business Website
What is your niche/specialty?*
SOCIAL MEDIA ACCOUNTS
Facebook*
Instagram*
Twitter*
LinkedIn*
Other
How many hours per month do you wish to work on Co-Op related items?*
How many hours per month do you wish to work on Co-Op related items?**
- 1-2
- 3+
How many months per year are you interested in working on Co-Op related items?*
How many months per year do you wish to work on Co-Op related items?*
- 3
- 6
- 9
- 12
On a scale of 1-10, how media savvy are you?*
Tech savvy, 1-10**
Social media savvy, 1-10**
Please check the deliverables you would like to receive from us.*
Please check the deliverables you would like to receive from us.**
- Select All
- Photo/bio on website
- Event promotion
- Speaker packet design
- In-network speaker endorsement
- Content development/training (articles, PowerPoint, blog, social media calendar)
- Webinar hosting
- Eblasting/cross-promotion
- Samples, giveaways, door prizes
- Ordering discount
- Annual retreat
- Training (P4 Dentistry/CariFree/Speaker development)
- Quarterly collaboration phone calls
- Professional development scholarship
Please check the deliverables you can provide this program.*
Please check the deliverables you can provide this program.**
- Speaking events
- Qualified lead list
- Event videos
- Facebook live videos
- Instagram live videos
- Social posts
- Blogs
- Articles
- Testimonials
- Patient case studies
- Eblasts to your network
- Webinars
- Online course development
- Video clips
- Podcast mentions
- Other
Please upload your CV, speaker packet, 250-word bio, and calendar of scheduled events.*
File
Drop files here or

Please allow our team 1-2 weeks to review your application and respond.

Questions? Email co-op@carifree.com!

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Professionals (866) 928-4445

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