Nikah Form

Please complete all sections of this form, if you require any assistance, please contact us on 02 9646 5972. This form is to be completed and submitted at least one week before the nikah ceremony.
Groom
Bride
Full Name

First NameLast Name
Full Name

First NameLast Name
Date of Birth:
Date of Birth:
Place of Birth:
Place of Birth:
Nationality
Nationality
Occupation:
Occupation:
Have You ever been Married before?

YesNo
Have you ever been Married before?

YesNo
Address Groom:

Street Address

Street Address Line 2

CityState

Postal CodeCountry
Address Bride:

Street Address

Street Address Line 2

CityState

Postal CodeCountry
E-mail/'s
Prefrences:

Hall Hire- Contact the mosque for further enquires if ticked.FoodDate
Any Other Prefrences: e.g. Time
It is a policy of Gallipoli Mosque that a civil marriage certificate is obtained as a pre requisite before any nikah ceremony can be performed.
Do you Have a Civil Marriage Certificate?*

Yes
x2 Witnesses Available

YesNoIf No, We can arrange witnesses if requested.
Thankyou.
Should be Empty: