Episcopal Diocese of Virginia
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Information Form for Holy Matrimony

(* Denotes Required Fields)

Please complete the following information.

Date of Application *
Requested Date of Ceremony *
Requested Time of Ceremony *
Specific Clergy Requested (if applicable)
Place of Ceremony *  
If the answer to the above question is "Other", please indicate location.
Holy Communion? *  
Requested Date of Rehearsal *
Requested Time of Rehearsal *
INFORMATION ABOUT THE BRIDE
Bride's Full Name *
Current Residence (Address, City, State, Zip) *
Home Phone *
Work or Cell Phone *
FAX Number
e-mail address *
Occupation *
Marital Status *  
Number of This Marriage *
Date of Birth (Month/Day/Year) *
Place of Birth (City/State/Country) *
Baptized? *  
Current Church Membership (Name, Location)
If the answer above is "Yes", what denomination?
Confirmed? *  
If answer to above is "Yes", what denomination?
Father's Full Name *
Mother's Maiden Name *
Parents' Current Residence *
INFORMATION ABOUT THE GROOM
Groom's Full Name *
Current Residence (Address, City, State, Zip) *
Home Phone *
Work or Cell Phone *
FAX Number
eMail Address *
Occupation *
Marital Status *  
Number of This Marriage *
Date of Birth (Month/Day/Year) *
Place of Birth (City, State, Country) *
Baptized? *  
Current Church Membership (Name, Location)
If the answer above is "Yes", what denomination?
Confirmed? *  
If the answer above is "Yes", what denomination?
Father's Full Name *
Mother's Maiden Name *
Parents' Current Residence *
Permanent address and new telephone numbers after marriage (if known)
Why do you wish to be married at Grace Episcopal Church? *
How did you learn about Grace Episcopal Church? *


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