DCP Academy Festival Shout-Out FormGive a shout out to your dancer and/or to Mr. Andrew, Ms. Kate, or your DCP Academy site instructor in our Academy Festival program book at the affordable rate of $20! Each shout-out will be approximately two lines of text. Student's Name: Sibling's Name (if applicable): Which Shout Outs would you like to buy? Student Shout Out! - $20Sibling Shout Out! - $15Instructor Shout Out! - $20 I’d like to place a shout-out to a DCP Academy student - $20.00 If you have more than one child in the Academy, you may include both children within your two lines of text. If you would like a completely separate shout-out for your second child, you may place another at the discounted rate of $15.00. My text (not to exceed 200 characters, including spaces)*: *Be sure to include your child's name and how you want it signed (i.e. Love, Mom and Dad) I’d like to place a shout-out to a DCP Academy sibling - $15.00 My text (not to exceed 200 characters, including spaces)*: *Be sure to include your child's name and how you want it signed (i.e. Love, Mom and Dad) I’d like to place a shout-out to Mr. Andrew, Ms. Kate, or your DCP Academy instructor - $20.00 My text (not to exceed 200 characters, including spaces)*: *Be sure to include how you want it signed (i.e. From the Robinson Family) Contact Information First Name Last Name Business Name Phone Email Address Line 1 Address Line 2 City StatePlease select...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingPuerto RicoVirgin IslandNorthern Mariana IslandsGuamAmerican SamoaPalau Postal Code Payment MethodCheckCredit CardPayment Information Name on Card Card Number MM YY Code Billing EmailChecks can be made payable to: Dancing Classrooms PhillyAttn: Academy Ad Book 4226 Spruce Street Philadelphia, PA 19104 Authnet_Hidden_Fields Contact Information