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Richard M. Bates SMILE Fund Application

Please ensure you have enough time to complete and submit this application — with required documentation — in one sitting, as it does not “save as you go”.


Richard M. Bates SMILE Fund Application

The purpose of the Richard M. Bates SMILE Fund to provide critical dental healthcare for music industry professionals with limited financial means.

  • How many family members do you claim on your tax return?
  • What do you do and for how long have you been doing it?
  • There is no wrong answer.
    If you answer YES, please answer to the last question so we can better assist you. If you are NEW to MHA, please click submit and we will be back in touch shortly.
  • Please select the advocate that you have worked with previously at Music Health Alliance.
  • REQUIRED: Please select 2 of the following 4 document options to upload as proof of need: 1. Most Recent Tax Return 2. Most Recent Bank Statement 3. Employment or Unemployment Check Stub or Direct Deposit Documentation 4. Alternative Proof of Need Documentation or Letter of Explanation
    Drop files here or
    Max. file size: 100 MB, Max. files: 2.
    • This field is for validation purposes and should be left unchanged.