To Trust Again - Gulf Breeze

Please indicate your choice for a date:*

His First Name*

His Last (Family) Name*

Suffix:

Nickname (Optional):

Her First Name:*

Her Last (Family) Name*

Nickname (Optional):

Select your Parish:*

Name of Priest or Deacon helping you prepare for marriage:

City/Parish of Priest or Deacon helping you prepare:

Priest or Deacon witnessing your marriage:

Have you taken either the FOCCUS, PREPARE / ENRICH, or Fully Engaged Inventory?*

yesno

Date of wedding (if known):

Date

Where are you planning to have your wedding?*

Where (city/ state) will you reside after marriage?*

Are you currently co-habitating (living together)?*

NoYes

For how long co-habitating?

Are you currently civilly married?*

NoYes

For how long civilly married?

HIS PERSONAL INFORMATION

His Street Address:*

His City:*

His State/Province:*

His ZIP:*

His Daytime phone:*

His e-mail:*

His religion/denomination:*

His age:

HER PERSONAL INFORMATION

Her Street Address:*

Her City:*

Her State/Province:*

Her ZIP:*

Her Daytime phone:*

Her e-mail:*

Her religion/denomination:*

Her age:

Does he have children?*

YesNo

Information on HIS child(ren): Please enter Age / Gender / Custody for each child: (Choose J, F, N for Custody where J=joint, F=full, N=none)

Does she have children?*

YesNo

Information on HER child(ren). Please enter Age / Gender / Custody for each child: (Choose J, F, N for Custody where J=joint, F=full, N=none)

Has he been married previously?*

YesNo

For how long?

Was ceremony Church or Civil?*

ChurchCivil

How did marriage end?*

DivorceDeathNeither

How long single?

Regarding an annulment:

Not consideredIn processCompleted

Has she been married previously?*

YesNo

For how long?

Was ceremony Church or Civil?*

ChurchCivil

How did marriage end?*

DivorceDeathNeither

How long single?

Regarding an annulment:

Not consideredIn processCompleted

The fee for this event is $100. Please select a payment method*

pay onlineI will mail a check

If you are mailing a check, make it payable to:

The Diocese of Pensacola-Tallahassee

and send your check to:

Diocese of Pensacola-Tallahassee

attn: Office of Marriage & Family Life

P.O. Drawer 13284

Pensacola, FL 32591-3284

You can pay online with a credit or debit card or use your checking or savings account on our secure web page through Vanco Payment Solutions. After clicking [Submit & Pay Now], you'll be taken to our payment page. You may print this registration form for your records.