"Mom-inate" a mom as Chief Health Officer by completing the entry form below and upload a 30-second video explaining why your mom, maternal guardian, or a mom you know should be named America's Chief Health Officer - and be sure to explain how milk plays an important role in your family's diet!

Don't have a video camera? No problem! Just submit an essay (50-words or less) explaining why the mom you know is worthy of the title, Chief Health Officer, by typing your entry in the field below.

In October, 100 finalists will be posted online and America will be invited to vote for the mom they think best represents America's Chief Health Officer. Ultimately, one grand prize winner will be rewarded with the chance to star with her family in a Milk Mustache ad, plus a year's supply of milk, a three-month complimentary Curves membership and a one-year subscription to Redbook.

Chief Health Officer Entry Form

First Name

Last Name

Address

City

State
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
ZIP

Date of Birth
You must be 13 years or older to enter.
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Phone
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Email

First Name of Mom Being Submitted

Last Name of Mom Being Submitted

Video:


50-Word Essay:


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