Surname of Groom: Click or tap here to enter text.

Christian name(s):Click or tap here to enter text.

Date of Birth:Click or tap to enter a date.

Occupation:Click or tap here to enter text.

Contact Address: Click or tap here to enter text.

Postcode:Click or tap here to enter text.

Phone No:Click or tap here to enter text.

Mobile No:Click or tap here to enter text.

Email:Click or tap here to enter text.

Do you have Qualifying Connection?*

Yes☐	No☐

Banns Address:Click or tap here to enter text.

From (date):Click or tap to enter a date.

Parish Church: Click or tap here to enter text.

Preferred Date of Wedding:Click or tap to enter a date.

Preferred time:Click or tap here to enter text.

Father’s Full Name:Click or tap here to enter text.

Occupation:Click or tap here to enter text.

Mother’s Full name:Click or tap here to enter text.

Occupation:Click or tap here to enter text.

Have you been married before?

Yes☐ No☐

If you answered Yes please answer below as appropriate.

Are you a widower? Yes☐ No☐

Are you divorced? Yes☐# No☐

If you are divorced, do you have a decree absolute? No ☐

Yes☐ Date: Click or tap to enter a date.

I hereby certify that the above answers to the questions are correct to the best of my belief.

Signature:

Date:Click or tap to enter a date.

Deposit paid:☐

*Please see descriptions of qualifying connection and discuss with the weddings coordinator if necessary.

#Please arrange an appointment with a member of the clergy for a discussion.

Surname of Bride: Click or tap here to enter text.

Christian name(s):Click or tap here to enter text.

Date of Birth:Click or tap to enter a date.

Occupation:Click or tap here to enter text.

Contact Address: Click or tap here to enter text.

Postcode:Click or tap here to enter text.

Phone No:Click or tap here to enter text.

Mobile No:Click or tap here to enter text.

Email:Click or tap here to enter text.

Do you have Qualifying Connection?*

Yes☐	No☐

Banns Address:Click or tap here to enter text.

From (date):Click or tap here to enter text.

Parish Church: Click or tap here to enter text.

Preferred Date of Wedding:Click or tap to enter a date.

Preferred time:Click or tap here to enter text.

Father’s Full Name:Click or tap here to enter text.

Occupation:Click or tap here to enter text.

Mother’s Full name:Click or tap here to enter text.

Occupation:Click or tap here to enter text.

Have you been married before?

Yes☐ No☐

If you answered Yes please answer below as appropriate.

Are you a widower? Yes ☐No☐

Are you divorced? Yes ☐#No☐

If you are divorced, do you have a decree absolute? No ☐

Yes ☐ Date:Click or tap to enter a date.

I hereby certify that the above answers to the questions are correct to the best of my belief.

Signature:

Date:Click or tap to enter a date.

Deposit paid: ☐

*Please see descriptions of qualifying connection and discuss with the weddings coordinator if necessary.

#Please arrange an appointment with a member of the clergy for a discussion.