In my efforts to provide you the best possible service, please complete all sections.

Who Do I Contact:

Contact Bride	By telephone  By E-mail
Contact Groom	By telephone  By E-mail
Best Time (m-f after 5)

Brides Information:

Name:
Address:
City:
State, Zip:
County:
Telephone:
E-mail:

Date of Birth:
Previously Married:	Yes  No

Grooms Information:

Name:
Address:
City:
State, Zip:
County
Telephone:
E-mail:

Date of Birth:
Previously Married:	Yes  No

Ceremony Information:

WEDDING DATE AND TIME	____ January February March April May June July August September October November December    __ 1 2 3 4 5 6 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    ____ 2009 2010 2011 2012   Time:
Marriage License County: (Ohio Law states you must obtain your Marriage License from the county you live in. You can however, have your marriage solemnized in any Ohio county.) If I am officiating your ceremony and you are from out of state, you must obtain your marriage license from Montgomery County Ohio
Type of Ceremony Simple informal Christian or Civil ceremonies at my home. You may have up to two guest.	Please Select Christian - Non-Denominational Civil Ceremony
Are you exchanging rings?	Yes       No

Additional Comments:

Monday - Friday: $50.00 | Saturday - Sunday: $50.00 | Holidays: $50.00
No Deposit Required. Payment Due Day of Wedding