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Marriage by Proxy

Bride’s Information Sheet

Bride's Full Name

First, Middle, Last

Bride's Date of Birth

Month, Day, Year

Bride's Most Recent Street Address

Bride's Phone Number

include area code and country code

Bride's Email Address

Bride's Mother's Full Name

First, Middle, Last

Bride's Father's Full Name

First, Middle, last

Is this the bride's first marriage?
 yes no

Have the bride and groom met in the same physical location?
 yes no

Groom's Full Name


Are you military?
 yes no

Active or Honorably Discharged