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? *

yes no

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)? *

No Yes

For how long co-habitating?

Are you currently civilly married? *

No Yes

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? *

Yes No

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? *

Yes No

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? *

Yes No

For how long?

Was ceremony Church or Civil? *

Church Civil

How did marriage end? *

Divorce Death Neither

How long single?

Regarding an annulment:

Not considered In process Completed

Has she been married previously? *

Yes No

For how long?

Was ceremony Church or Civil? *

Church Civil

How did marriage end? *

Divorce Death Neither

How long single?

Regarding an annulment:

Not considered In process Completed

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

pay online I 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.