BMEC Gift Certificate Order Form
Give the Gift of Music!
Name of Person Giving the Gift of Music
*
First Name
Last Name
Person Giving the Gift of Music Email
*
example@example.com
Person Giving the Gift of Music Email Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Student's Name
*
First Name
Last Name
Student's Birthday
*
-
Month
-
Day
Year
Date
Student's Primary Guardian
*
First Name
Last Name
Primary Guardian's Email Address
*
example@example.com
Primary Guardian's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Student's Secondary Guardian
*
First Name
Last Name
Secondary Guardian's Email Address
*
example@example.com
Secondary Guardian's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Student's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Class Type for Student
*
Please Select
Musical Beginnings - Ages 6-24 months
Music for Little People - Age 2
Music for Little People - Age 3
4's/5's Encounters - Age 4/5
Term for which you giving the gift of music
*
Winter Spring 2026
Summer 2026
Fall Winter 2026/2027
Winter Spring 2027
Summer 2027
Enter the DOLLAR AMOUNT you'd like to add to your Student's Gift Certificate:
*
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( X )
USD
Please note that the guardians will be contacted upon receipt of this gift certificate to choose the class time. Based on the amount of the Gift Certificate, additional fees may be applied to the guardians. Please also note that all Waivers and Policies of the BMEC program will be in effect. No cash refunds.
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