Solemnization Form
Title 1, Canon XIX, Section 3(c)
To:
The Ecclesiastical Authority of the Dioceses of Western New York & Northwestern Pennsylvania
Clergy Email
*
example@example.com
This is to certify that the marriage of (Name 1):
*
First Name
Last Name
And (Name 2)
*
First Name
Last Name
Was solemnized by me on
*
-
Month
-
Day
Year
Date
At (Congregation name and city)
*
Parish
City
Within the Diocese of
*
WNY
NWPA
Clergy Signature (typing your full name serves as your signature)
*
Date of Signature:
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: