Actors Playhouse Group Interest Form

Your comments are appreciated!

group name:		(e.g. Good Neighbors Social Group)
group representative:		(e.g. John Doe)
approx. # of people in group:
group type:		Choose One Mixed Age Group Senior Citizen Group Adult Group Fundraiser Meeting/Convention Group
show(s) of interest:		(e.g. Irving Berlin’s White Christmas)
show preferences:		Matinee  Evening  No preference
		Day/dates: (e.g. Fri. or 12/23-12/31)
group's address:
group's city:
group's state:		Choose State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
group's zip code:
representative's address:
representative's city:
representative's state:		Choose State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
representative's zip code:
representative's daytime phone:
cell phone:
representative's email address:
comments/questions: