Name of the theater group *

Name of the Play *

Name of the director or contact Person *

Telephone Number of the director or contact Person *

Names of Participants(including support crew) - please use comma to separate *

Synopsis of play including DURATION, ORIGINAL PLAYWRIGHT/ADAPTED BY *

Past Performances: Brief description of team achievements, past performances and website (links to YouTube, photo albums, etc. can be included) *

Please mail a check for $500 payable to CAB mailed to Mr. Chitta Saha, 4 Entrance Way, Purdys, New York 10578. Please provide Bank name and Check # below *