Marriage Application Form

Marriage Application Form
Marriage Date*
*** PLEASE NOTE THAT THIS DATE IS NOT CONFIRMED UNTIL YOU RECEIVE AN EMAIL (NOT THE AUTOMATED EMAIL) FROM admin@hamiltonmosque.com WITH A CONFIRMATION OF THE EVENT.***
Partner A Information
Full Legal Name*

First NameLast Name
Age*
Date of Birth*

MonthDayYear
Date
Place of Birth*
Citizenship*
Religion*
Ethnicity*
Phone*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation/Job Title
Company Name
Driver's License No.*
Father's Name*

First NameLast Name
Mother's Name*

First NameLast Name
Previously married?*

YesNo
Required Supporting Documents
Copy of Valid IDs (Driver license, passport, or PR card) and Marriage License*

Cancelof
Agreement
- I confirm that all information in this document is accurate and true.
Partner A Signature*

Clear
Date Signed*

MonthDayYear
Date

Partner B Information
Full Legal Name*

First NameLast Name
Age*
Date of Birth*

MonthDayYear
Date
Place of Birth*
Citizenship*
Religion*
Ethnicity*
Phone*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation/Job Title
Company Name
Father's Name*

First NameLast Name
Mother's Name*

First NameLast Name
Previously married?*

YesNo
Required Supporting Documents
Copy of Valid IDs (Driver license, passport, or PR card) and Marriage License*

Cancelof
Agreement
- I confirm that all information in this document is accurate and true.
Partner B Signature*

Clear
Date Signed*

MonthDayYear
Date

Additional Details
Any special instructions?
Preferred Imam (This will be based on the availability of the Imam)*

Dr. Reda BedeirHafez Asjed
Are you a member?*

YesNo
Do you require off-site services? *

YesNo
Marriage license fee

Marriage License Fee*

CADPlease note that there is an additional $100 fee for off-site services

Partner A Information