Islamic Center of Naperville - Nikah Registration Application

Nikah Registration Application

The Messenger of Allah said: “Marriage is part of my sunnah"
Name of the person submitting the application:

First NameLast Name
Email of the person submitting the application:
example@example.com
Phone Number of the person submitting the application:
Format: (000) 000-0000.
Name of the Groom:

First NameLast Name
Groom's Father's Name:

First NameLast Name
Groom's date of birth:

MonthDayYear
Date
Groom's Religion:
Name of the Bride:

First NameLast Name
Bride's Father Name:

First NameLast Name
Bride's date of birth:

MonthDayYear
Date
Bride's Religion:
Name of the bride's wali:

First NameLast Name
Relationship of Wali to the Bride:
Name of Male Witness #1:
Name of Male Witness #2:
Mahr Amount:
Enter an amount in $ (dollars)
Mahr amount to be paid at the time of the wedding:
Enter an amount in $ (dollars)
Mahar amount deferred:
Mahr amount - Mahr amount paid at the time of wedding in $ (dollars)
Have both parties agreed upon the mahr amount?
Date of Nikah/Time

MonthDayYear
Date
Hour MinutesAM/PM Option
Which Islamic Center of Naperville location is the Nikah planned to take place (subject to availability)?

Other
How many people are you expecting at your ceremony?
Who would you like to perform your nikah? (subject to availability)?
We agree to obtain a marriage license from the county where the Nikah will take place before the Nikkah ceremony:
I want a pre-marital religious counseling session with the Imam.
A session with our Imams can be scheduled by visiting Our Shuyookh
Is there any other information you would like to share?
I agree that the above information I provided is correct and true to the best of my knowledge.

My Products

ICN Nikah Registration Application

Registration fees covers ICN Nikah certificate

$250.00

Total

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty: