Movie Night Voting Form
Help us choose the next movie and make our movie night a great experience for everyone!
Your Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Which movie would you like to watch?
*
Inception
The Shawshank Redemption
The Dark Knight
Forrest Gump
Other (please specify)
Select up to 3 genres you prefer for movie night:
*
Action
Comedy
Drama
Science Fiction
Horror
Romance
Animation
Other
Which date works best for you?
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Would you like to bring a guest?
*
Yes
No
Please rate the last movie night experience
1
2
3
4
5
What snacks would you like to have? (Select all that apply)
Popcorn
Chips
Candy
Pizza
Other (please specify)
How would you prefer to watch the movie?
*
At someone's home
Outdoor screening
Community center
Other
Suggest a movie for future nights
Any additional comments or suggestions?
Submit Vote
Should be Empty: