Marriage Registration Form
1.
Field Is Required
Bride First Name
2.
Field Is Required
Bride Last Name
3.
Field Is Required
Email
4.
Field Is Required
Phone
5.
Field Is Required
Address: Street City, ST Zip
6.
Employer/ Occupation
7.
Field Is Required
Bride Home Parish
8.
Basilica Registered Member?
Please select response
Yes
No
9.
Baptized Catholic?
(Select one of the available choices or enter a different value.)
Baptized Catholic? Click this to indicate that you will select an existing value. Tab to next input."
Baptized Catholic?
Please select response
Yes
No
Baptized Catholic? Click this to indicate that you will enter a new value. Tab to next input."
Baptized Catholic? Provide your answer here
10.
Confirmed Catholic?
(Select one of the available choices or enter a different value.)
Confirmed Catholic? Click this to indicate that you will select an existing value. Tab to next input."
Confirmed Catholic?
Please select response
Yes
No
Confirmed Catholic? Click this to indicate that you will enter a new value. Tab to next input."
Confirmed Catholic? Provide your answer here
11.
Bride Previous Marriage
Please select response
No
Yes. Spouse has deceased
Yes. Divorced. Declaration of Nullity
Yes. Divorced. No Declaration of Nullity
12.
Please list children from previous marriage if applicable.
13.
Field Is Required
Groom First Name
14.
Field Is Required
Groom Last Name
15.
Field Is Required
Email
16.
Field Is Required
Phone
17.
Field Is Required
Address: Street City, ST Zip
18.
Employer/ Occupation
19.
Field Is Required
Groom Home Parish
20.
Basilica Registered Member?
Please select response
Yes
No
21.
Baptized Catholic?
(Select one of the available choices or enter a different value.)
Baptized Catholic? Click this to indicate that you will select an existing value. Tab to next input."
Baptized Catholic?
Please select response
Yes
No
Baptized Catholic? Click this to indicate that you will enter a new value. Tab to next input."
Baptized Catholic? Provide your answer here
22.
Confirmed Catholic?
(Select one of the available choices or enter a different value.)
Confirmed Catholic? Click this to indicate that you will select an existing value. Tab to next input."
Confirmed Catholic?
Please select response
Yes
No
Confirmed Catholic? Click this to indicate that you will enter a new value. Tab to next input."
Confirmed Catholic? Provide your answer here
23.
Groom Previous Marriage
Please select response
No
Yes. Spouse has deceased
Yes. Divorced. Declaration of Nullity
Yes. Divorced. No Declaration of Nullity
24.
Please list children from previous marriage if applicable.
25.
Marriage Preparation
Please select response
Yes, planning to do at The Basilica
No, planning to elsewhere
26.
Are there specific wedding dates you are interested in?
(Maximum response 255 chars, approx. 5 rows of text)
27.
Requested Priest from The Basilica
Visiting Presider Requested?
28.
Visiting Presider Requested?
Please select response
Yes
No
29.
Name of requested visiting presider, his parish or religious community, and location of parish or religious community
Spam Control Text:
Please leave this field empty
