DCP Academy Shout Out Form - Dancing Classrooms Philadelphia

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}  #tfa_3011, *[id^="tfa_3011["] { width: 190px !important; } #tfa_3011-D, *[id^="tfa_3011["][class~="field-container-D"] { width: auto !important; }  #tfa_3011-L, label[id^="tfa_3011["] { width: 130px !important; min-width: 0px; } </style><div class=""><div class="wForm" id="4719339-WRPR" dir="ltr"><div class="codesection" id="code-4719339"></div><h3 class="wFormTitle" id="4719339-T"><span style="font-size: 23.04px;">DCP Academy Festival Shout-Out Form</span></h3><form method="post" action="https://www.tfaforms.com/responses/processor" class="hintsBelow labelsLeftAligned" id="4719339" role="form"><div class="htmlSection" id="tfa_2999"><div class="htmlContent" id="tfa_2999-HTML"><b>Give 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. </b></div></div><div class="oneField field-container-D " id="tfa_2956-D"><label id="tfa_2956-L" class="label preField " for="tfa_2956">Student's Name: </label><div class="inputWrapper"><input type="text" id="tfa_2956" name="tfa_2956" value="" title="Student's Name: " data-dataset-allow-free-responses="" class=""></div></div><div class="oneField field-container-D " id="tfa_2960-D"><label id="tfa_2960-L" class="label preField " for="tfa_2960">Sibling's Name (if applicable): </label><div class="inputWrapper"><input type="text" id="tfa_2960" name="tfa_2960" value="" title="Sibling's Name (if applicable): " data-dataset-allow-free-responses="" class=""></div></div><div class="oneField field-container-D " id="tfa_3000-D" role="group" aria-labelledby="tfa_3000-L"><label id="tfa_3000-L" class="label preField ">Which Shout Outs would you like to buy? </label><div class="inputWrapper"><span id="tfa_3000" class="choices vertical "><span class="oneChoice"><input type="checkbox" value="tfa_3001" class="" id="tfa_3001" name="tfa_3001" aria-labelledby="tfa_3000-L tfa_3001-L"><label class="label postField" id="tfa_3001-L" for="tfa_3001"><span class="input-checkbox-faux"></span>Student Shout Out! - $20</label></span><span class="oneChoice"><input type="checkbox" value="tfa_3002" class="" id="tfa_3002" name="tfa_3002" aria-labelledby="tfa_3000-L tfa_3002-L"><label class="label postField" id="tfa_3002-L" for="tfa_3002"><span class="input-checkbox-faux"></span>Sibling Shout Out! - $15</label></span><span class="oneChoice"><input type="checkbox" value="tfa_3003" class="" id="tfa_3003" name="tfa_3003" aria-labelledby="tfa_3000-L tfa_3003-L"><label class="label postField" id="tfa_3003-L" for="tfa_3003"><span class="input-checkbox-faux"></span>Instructor Shout Out! - $20</label></span></span></div></div><div id="tfa_2962" class="section inline group"><div class="htmlSection" id="tfa_2955"><div class="htmlContent" id="tfa_2955-HTML"></div></div><div class="oneField field-container-D labelsAbove " id="tfa_2961-D"><label id="tfa_2961-L" class="label preField " for="tfa_2961"><span style="font-weight: 700;">I’d like to place a shout-out to a DCP Academy student - $20.00 </span>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) </label><br><div class="inputWrapper"><textarea id="tfa_2961" name="tfa_2961" title="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) " class=""></textarea></div></div><div class="oneField field-container-D " id="tfa_2964-D"><label id="tfa_2964-L" class="label preField " for="tfa_2964"><span style="font-weight: 700;">I’d like to place a shout-out to a DCP Academy sibling - $15.00 </span>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) </label><div class="inputWrapper"><textarea id="tfa_2964" name="tfa_2964" title="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) " class=""></textarea></div></div><div class="oneField field-container-D " id="tfa_2992-D"><label id="tfa_2992-L" class="label preField " for="tfa_2992"><b>I’d like to place a shout-out to Mr. Andrew, Ms. Kate, or your DCP Academy instructor - $20.00</b>My text (not to exceed 200 characters, including spaces)*:*Be sure to include how you want it signed (i.e. From the Robinson Family)</label><div class="inputWrapper"><textarea id="tfa_2992" name="tfa_2992" title="I’d like to place a shout-out to Mr. Andrew, Ms. Kate, or your DCP Academy instructor - $20.00 My text (not to exceed 200 characters, including spaces)*: *Be sure to include how you want it signed (i.e. From the Robinson Family) " class=""></textarea></div></div></div><fieldset id="tfa_12" class="section"><legend id="tfa_12-L">Contact Information</legend><div id="tfa_2567" class="section group"><div class="oneField field-container-D " id="tfa_2568-D"><label id="tfa_2568-L" class="label preField " for="tfa_2568">First Name </label><div class="inputWrapper"><input type="text" id="tfa_2568" name="tfa_2568" value="" title="First Name " 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/^([$]{1}[0-9]{3}[$]{1}[\.| |\-]{0,1}|^[0-9]{3}[\.|\-| ]?)?[0-9]{3}(\.|\-| )?[0-9]{4}$/"></div></div><div class="oneField field-container-D " id="tfa_2571-D"><label id="tfa_2571-L" class="label preField " for="tfa_2571">Email</label><div class="inputWrapper"><input type="text" id="tfa_2571" name="tfa_2571" value="" title="Email" data-dataset-allow-free-responses="" class="validate-email"></div></div><div class="oneField field-container-D " id="tfa_2572-D"><label id="tfa_2572-L" class="label preField " for="tfa_2572">Address Line 1</label><div class="inputWrapper"><input type="text" id="tfa_2572" name="tfa_2572" value="" title="Address Line 1" data-dataset-allow-free-responses="" class=""></div></div><div class="oneField field-container-D " id="tfa_2573-D"><label id="tfa_2573-L" class="label preField " for="tfa_2573">Address Line 2</label><div class="inputWrapper"><input type="text" id="tfa_2573" name="tfa_2573" value="" title="Address Line 2" data-dataset-allow-free-responses="" 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class="">Massachusetts</option><option value="tfa_2836" id="tfa_2836" class="">Michigan</option><option value="tfa_2837" id="tfa_2837" class="">Minnesota</option><option value="tfa_2838" id="tfa_2838" class="">Mississippi</option><option value="tfa_2839" id="tfa_2839" class="">Missouri</option><option value="tfa_2840" id="tfa_2840" class="">Montana</option><option value="tfa_2841" id="tfa_2841" class="">Nebraska</option><option value="tfa_2842" id="tfa_2842" class="">Nevada</option><option value="tfa_2843" id="tfa_2843" class="">New Hampshire</option><option value="tfa_2844" id="tfa_2844" class="">New Jersey</option><option value="tfa_2845" id="tfa_2845" class="">New Mexico</option><option value="tfa_2846" id="tfa_2846" class="">New York</option><option value="tfa_2847" id="tfa_2847" class="">North Carolina</option><option value="tfa_2848" id="tfa_2848" class="">North Dakota</option><option value="tfa_2849" id="tfa_2849" class="">Ohio</option><option value="tfa_2850" id="tfa_2850" 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class="">Puerto Rico</option><option value="tfa_2866" id="tfa_2866" class="">Virgin Island</option><option value="tfa_2867" id="tfa_2867" class="">Northern Mariana Islands</option><option value="tfa_2868" id="tfa_2868" class="">Guam</option><option value="tfa_2869" id="tfa_2869" class="">American Samoa</option><option value="tfa_2870" id="tfa_2870" class="">Palau</option></select></div></div><div class="oneField field-container-D " id="tfa_2886-D"><label id="tfa_2886-L" class="label preField " for="tfa_2886">Postal Code</label><div class="inputWrapper"><input type="text" id="tfa_2886" name="tfa_2886" value="" title="Postal Code" data-dataset-allow-free-responses="" class="validate-integer"></div></div></div></fieldset><div class="oneField field-container-D " id="tfa_2896-D" role="radiogroup" aria-labelledby="tfa_2896-L"><label id="tfa_2896-L" class="label preField ">Payment Method</label><div class="inputWrapper"><span id="tfa_2896" class="choices horizontal "><span class="oneChoice"><input type="radio" value="tfa_2897" class="" id="tfa_2897" name="tfa_2896" aria-labelledby="tfa_2896-L tfa_2897-L"><label class="label postField" id="tfa_2897-L" for="tfa_2897"><span class="input-radio-faux"></span>Check</label></span><span class="oneChoice"><input type="radio" value="tfa_2899" class="" id="tfa_2899" name="tfa_2896" data-conditionals="#tfa_3004" aria-labelledby="tfa_2896-L tfa_2899-L"><label class="label postField" id="tfa_2899-L" for="tfa_2899"><span class="input-radio-faux"></span>Credit Card</label></span></span></div></div><fieldset id="tfa_3004" class="section" data-condition="`#tfa_2899`"><legend id="tfa_3004-L">Payment Information</legend><div class="oneField field-container-D " id="tfa_3005-D"><label id="tfa_3005-L" class="label preField reqMark" for="tfa_3005">Name on Card</label><div class="inputWrapper"><input type="text" id="tfa_3005" name="tfa_3005" value="" aria-required="true" title="Name on Card" data-dataset-allow-free-responses="" class="required"></div></div><div class="oneField field-container-D " id="tfa_3006-D"><label id="tfa_3006-L" class="label preField reqMark" for="tfa_3006">Card Number</label><div class="inputWrapper"><input type="text" id="tfa_3006" name="tfa_3006" value="" placeholder="●●●●●●●●●●●●●●●●" aria-required="true" title="Card Number" data-dataset-allow-free-responses="" class="required"></div></div><div id="tfa_3007" class="section inline group"><div class="oneField field-container-D " id="tfa_3008-D"><label id="tfa_3008-L" class="label preField reqMark" for="tfa_3008">MM</label><div class="inputWrapper"><input type="text" id="tfa_3008" name="tfa_3008" value="" placeholder="MM" aria-required="true" title="MM" data-dataset-allow-free-responses="" class="required"></div></div><div class="oneField field-container-D " id="tfa_3009-D"><label id="tfa_3009-L" class="label preField reqMark" for="tfa_3009">YY</label><div class="inputWrapper"><input type="text" id="tfa_3009" name="tfa_3009" value="" placeholder="YY" aria-required="true" title="YY" data-dataset-allow-free-responses="" class="required"></div></div><div class="oneField field-container-D " id="tfa_3010-D"><label id="tfa_3010-L" class="label preField reqMark" for="tfa_3010">Code</label><div class="inputWrapper"><input type="text" id="tfa_3010" name="tfa_3010" value="" placeholder="●●●" aria-required="true" title="Code" data-dataset-allow-free-responses="" class="required"></div></div></div><div class="oneField field-container-D " id="tfa_3011-D"><label id="tfa_3011-L" class="label preField reqMark" for="tfa_3011">Billing Email</label><div class="inputWrapper"><input type="text" id="tfa_3011" name="tfa_3011" value="" aria-required="true" title="Billing Email" data-dataset-allow-free-responses="" class="validate-email required"></div></div></fieldset><div class="htmlSection" id="tfa_2951"><div class="htmlContent" id="tfa_2951-HTML">Checks can be made payable to: <br>Dancing Classrooms Philly<br>Attn: Academy Ad Book<br>4226 Spruce Street<br>Philadelphia, PA 19104<br></div></div><div id="Authnet_Hidden_Fields" class="section column group wf-acl-hidden"><label class="label preField" id="Authnet_Hidden_Fields-L">Authnet_Hidden_Fields</label><input type="hidden" id="AUTHORIZE_DOT_NET_TRANSACTION_ID" name="AUTHORIZE_DOT_NET_TRANSACTION_ID" value="" class=""><input type="hidden" id="AUTHORIZE_DOT_NET_SUBSCRIPTION_ID" name="AUTHORIZE_DOT_NET_SUBSCRIPTION_ID" value="" class=""><input type="hidden" id="AUTHORIZE_DOT_NET_AUTH_TOKEN" name="AUTHORIZE_DOT_NET_AUTH_TOKEN" value="" class=""></div><div class="actions" id="4719339-A"><input type="submit" data-label="Submit" class="primaryAction" id="submit_button" value="Submit"></div><div style="clear:both"></div><input type="hidden" value="4719339" name="tfa_dbFormId" id="tfa_dbFormId"><input type="hidden" value="" name="tfa_dbResponseId" id="tfa_dbResponseId"><input type="hidden" value="3edd647df770e1ecb10fd18502a57745" name="tfa_dbControl" id="tfa_dbControl"><input type="hidden" value="11" name="tfa_dbVersionId" id="tfa_dbVersionId"><input type="hidden" value="" name="tfa_switchedoff" id="tfa_switchedoff"></form></div></div><div class="wFormFooter"><p class="supportInfo"><a target="new" class="contactInfoLink" href="https://www.tfaforms.com/forms/help/4719323">Contact Information</a><br></p></div> <p class="supportInfo" >  </p> </div>