Gift of Dance

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Gift of Dance

Thank you for your kind heart and generosity! Please use form below to provide the information to give the gift of dance.

Once the form and payment have been received you'll receive an email within 24 hours containing the gift certificate that you can print or email to the gift recipient.

Email *

Today's date

YYYY

Your First and Last Name
*

Your phone number
*

Gift recipient's First and Last Name

Gift recipient's email

Gift recipient's phone number

Gift Amount
*

$55 / one month of dance for Empowered By Movement class

$20 / one month access to our Dance on Demand video library

Other:

Required

Payment Method
*

PayPal via this link https://PayPal.Me/empowermentdance

Check payable to: Empowerment Dance, 1150 Grignon Street, Green Bay, WI 54301

Other:

Required

A copy of your responses will be emailed to the address you provided.

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