Marriage by Proxy

Groom's Full Name

First, Middle, Last

Groom's Date of Birth

Month, Day, Year

Groom's Most Recent Street Address

Groom's Phone Number

include area code and country code

Groom's Email Address

Groom's Mother's Full Name

First, Middle, Last

Groom's Father's Full Name

First, Middle, last

Is this the groom's first marriage?

yes no

Have the groom and bride met in the same physical location?

yes no

Bride's Full Name

First,Middle,Last

Are you military?

yes no

Active or Honorably Discharged