Eligibility for Marriage Form
Name
*
First Name
Middle Name
Last Name
Birth Date
*
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Year
Place of Birth
City, State, Country
Upload ID/DL/Passport
*
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Photo
*
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State of Issued ID
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
ID Number
Immigration Status
U.S. Citizen
Legal Resident
Other
Details of Attendance
Rows
Weekly
Monthly
Occasionally
Liturgies
Meetings
Parish
St. Mark - Burr Ridge, IL
St. Mary - Palatine, IL
St. George - Monee, IL
St. Paul - Chicago, IL
St. Mina & Pope Kyrillos - Champagne, IL
St. Mary - St. Paul, MN
St. George - Plymouth, MN
St. Mary & St Antonious - Oak Creek, WI
St. Mary & St. Rewais - Madison, WI
St. Mary - Des Moines, IA
St. Mary & St. Abraam - St. Louis, MO
St. Mary & St. George - Council Bluffs, IA
Father-of-Confession
Parish prior to immigration (if applicable)
Have you been previously married or engaged?
Yes
No
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Have you been previously married?
Yes
No
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Was this a civil or ecclesial marriage?
Civil
Ecclesial
Where were you married?
City, State
When were you married?
-
Month
-
Day
Year
Date
Do you have proof of your divorce and/or permit to re-marry?
Yes
No
Please upload proof of your divorce and/or your permit to re-marry.
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Do you have proof of your dissolution of engagement?
Yes
No
Please upload proof of your dissolution of engagement.
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Witness #1
*
First Name
Last Name
State of Issued ID
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
ID Number
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Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
(xxx) xxx-xxxx
Email
example@example.com
Witness #2
*
First Name
Last Name
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State of Issued ID
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
ID Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
(xxx) xxx-xxxx
Email
example@example.com
Parish
*
St. Mark - Burr Ridge, IL
St. Mary - Palatine, IL
St. George - Monee, IL
St. Paul - Chicago, IL
St. Mina & Pope Kyrillos - Champagne, IL
St. Mary - St. Paul, MN
St. George - Plymouth, MN
St. Mary & St Antonious - Oak Creek, WI
St. Mary & St. Rewais - Madison, WI
St. Mary - Des Moines, IA
St. Mary & St. Abraam - St. Louis, MO
St. Mary & St. George - Council Bluffs, IA
Priest
Date
*
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February
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September
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December
Month
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2
3
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5
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7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Supporting Documentation
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I testify that the information provided above is accurate.
Signature of Applicant
Signature of Witness #1
Signature of Witness #2
Signature of Priest
Priest Email
*
example@example.com
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