ICN Marriage Services Registration

Marriage Services

Registration Form
Purpose: This registration form is to initiate and document ICN marriage services. Please make sure to visit our website www.icntn.org/marriage for details on the process and fee. The information gathered in this form will be used to create the marriage certificate and contract, so please ensure it is accurate.

Process Summary:
1. Obtain a marriage license from your local county courthouse (this must be provided to the Imam before or at the marriage contract signing along with the return envelope).
2. Complete this marriage services registration form and pay the administrative fee: $100 for ICN Members or $300 for Non-Members. Pay via Card (debit or credit), Check (paper or electronic) to "ICN", PayPal, or Cash. Learn how to become a member here.
3. The bride, groom, wali, and 2 witnesses must attend the marriage aqd (Contract) signing on the designated date and bring a valid form of government identification with them (e.g. valid driver's license, passport, or ID).
Registration Form Instructions:
- Click "Next" to continue completing the following registration form.
- Items marked with an asterisk (*) require a response. You can save your responses to complete later by clicking on "Save for Later".
- Before beginning the form make sure to gather information about the bride, groom, parents, wali, and two witnesses (name, phone number, email, birth date, address, and ID numbers)
- This form will take approximately 15-20 minutes to complete.
Have questions? Email marriage@icntn.org, call or text 615-200-0379, or message us on WhatsApp.

VERIFICATION (IMAM USE ONLY)
Email*
example@example.com
Marriage Contract Signing Date*
(8th) day of (March) in the year (2019) corresponding to the (1st) day of (Rajab) in the year (1440 AH)This will show as-is in contract & certificate
Upload Marriage Documents to Google Drive

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GROOM INFORMATION
Groom Legal Name*

First NameMiddle NameLast Name
Groom Date of Birth*

MonthDayYear
Date
Groom ID - Type*
Groom ID - Number*
Groom ID - Issuing Government Authority*
Use Abbreviation of State or Country
Upload a Picture of Groom's ID*

*This is essential for us to verify spelling of name for marriage document*
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Groom Phone Number*
Please enter a valid phone number.
Groom Email*
example@example.com
Groom Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Groom Wali/Male Guardian Legal Name

First NameLast Name
Groom Mother/Female Guardian Legal Name

First NameLast Name

BRIDE INFORMATION
Bride Legal Name*

First NameMiddle NameLast Name
Bride Date of Birth*

MonthDayYear
Date
Bride ID - Type*
Bride ID - Number*
Bride ID - Issuing Government Authority*
Use Abbreviation of State or Country
Upload a Picture of Bride's ID*

*This is essential for us to verify spelling of name for marriage document*
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Bride Phone Number*
Please enter a valid phone number.
Bride Email*
example@example.com
Bride Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Bride Wali/Male Guardian Legal Name

First NameLast Name
Wali Relationship to Bride
Bride Mother/Female Guardian Legal Name

First NameLast Name
Bride Wali ID - Type
Bride Wali ID - Number
Bride Wali ID - Issuing Government Authority
Use Abbreviation of State or Country
If required Wali is not available, please explain why
In Islam, generally the Wali is required for the female to get married. Therefore, additional information is needed if no wali is provided

MAHR (BRIDAL GIFT)
At time of marriage contract:*
Brief description and amount (input N/A if not applicable)
To be paid at a later date:*
Brief description and amount (input N/A if not applicable)

WITNESS INFORMATION
Witness 1 Legal Name

First NameMiddle NameLast Name
Witness 1 Phone Number
Please enter a valid phone number.
Witness 1 Email
example@example.com
Witness 1 ID - Type
Witness 1 ID - Number
Witness 1 ID - Issuing Government Authority
Use Abbreviation of State or Country
Witness 2 Legal Name

First NameMiddle NameLast Name
Witness 2 Phone Number
Please enter a valid phone number.
Witness 2 Email
example@example.com
Witness 2 ID - Type
Witness 2 ID - Number
Witness 2 ID - Issuing Government Authority
Use Abbreviation of State or Country
If required witnesses are not available, please explain why
In Islam, generally two male witnesses are required for the couple to get married. Therefore, additional information is needed if no witnesses are available

MARRIAGE CONDITIONS
We recommend both parties to learn about their rights, responsibilities, and obligations in marriage. We recommend for both parties to read and understand the booklet that will be given by the authorized organization about the marriage.
List Any Special Marriage Condition(s) Agreed Upon to be Included in Marriage Contract*
Input "N/A" if none

OFF-SITE CEREMONY REQUEST (if applicable)
*Please note that the marriage processing fee does not ensure that an imam will come to an off-site location. If the Imams schedule allows for him to come, this is entirely a voluntary service provided to the community on his behalf. To schedule the Imam to come to a wedding location away from the Islamic Center of Nashville, please be sure to speak to the Imam directly.
Date of Wedding

MonthDayYear
Date
Location of Wedding

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Time Imam is requested to begin ceremony

CERTIFICATION & PAYMENT
The Groom and the Bride enter into this agreement to provide for circumstances relating to their marriage; and both have read and agreed to the following conditions by way of signing.*

We, the couple, verify that the above information is true to the best of our knowledge.We, the couple, recognize the efforts of the masjid to promote strong healthy relationships.We, the couple, understand and respect the necessity to begin the ceremony promptly, at its requested time, and promise to do our best to ensure that there is no unnecessary delay.We, the couple, recognize that neither the Islamic Center of Nashville, nor its affiliate counselors, will incur legal responsibility in matters related to the two parties.In case of any dispute among the parties mentioned in this document it is agreed that they must try resolve it by an Islamic arbitration first.I (we) authorize the Islamic Center of Nashville ("ICN") to send the applicable credit or debit entries (and adjustment entries), electronically or by any other commercially accepted method, to my (our) account(s) indicated and to other accounts I (we) identify in the future (the “Account”). This authorizes the financial institution holding the Account to post all such entries. I agree that the ACH transactions authorized herein shall comply with all applicable U.S. Law. This authorization will be in effect until the Organization receives a written termination notice from myself and has a reasonable opportunity to act on it.
Signature of the Groom*

Clear
Signature of the Bride*

Clear
Select the appropriate administrative fee based on your ICN Membership status:*

Marriage Services Fee (Member) - $100Marriage Services Fee (Non-Member) - $300
Method of Payment*

Pay by Card or PayPalPay by ACH/Electronic CheckPay by Paper Check or Cash at Office
Total Amount Due Now
Paid by Card or PayPal
Remaining Balance Due
Paid by ACH, Check, or Cash

Upload a picture of a voided check

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Card/PayPal Payment

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USD

	Account Type	Routing Number	Account Number
Account Details

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

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