Name:

Address:

City:

State / Zip:
/

Phone:

Email:

Theater Location:
Movieland 7 - Basalt, COCinema City at the Palace - Hartford, CTCriterion Cinemas® - New Haven, CTCriterion Cinemas at Greenwich Plaza - Greenwich, CTCriterion Cinemas® at Blue Back Square - West Hartford, CTLandmark 9 - Stamford, CTMajestic 6 - Stamford, CTMarquis 16 - Trumbull, CTPalace 17 & Odyssey Theater - Hartford, CTPlayhouse - New Canaan, CTRegent 8 - South Norwalk, CTRoyale 6 - Westport, CTWilton Cinema 4 - Wilton, CTAnnapolis Mall 11 - Annapolis, CTHarbour 9 - Annapolis Mall 11, Annapolis, CTAmerican Theater - Bronx, NYMovieland 6 - Schenectady, NYMovieland at Boulevard Square - Richmond, VAReston Town Center 13 - Reston, VA

Type of Event:

Date of Proposed Event:
/ / (mm/dd/yyyy)

Alternate Date:
/ / (mm/dd/yyyy)

Time of Proposed Event:
From: AMPM To: AMPM

Estimated # of Guests:

Event Details: