Name *

First Name

Last Name

Phone *

(###)

###

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Method of Financial Support *

Cash (in person)

Cheque (made payable to Give Me Brilliance Dance)

E-Transfer (to support@gmbdancer.com)

Share Name or Remain Anonymous *

I would like to share my name with the GMB Dance Community as a donor.

I would like my contribution to remain anonymous to the GMB Dance Community.