First, please give us your name, address, phone and email address.
Name:
Address:
City:
State:
Zip:
Phone:
Email address:
Now we need information regarding the resolution.
First and last names of couple:
Husband:
First:
Last:
Wife:
First:
Wife's Maiden Name:
City of residence:
Date of Celebration:
(Ex: Sunday, April 16, 2007)
Place of Celebration:
(Ex: Community Center, Smith Residence, etc.)
Place of Marriage:
(Ex: Community Church, Governor's Garden, etc.)
Month of Marriage:
Choose month
January
February
March
April
May
June
July
August
September
October
November
December
Day of Marriage:
Choose day
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
Year of Marriage:
Names of Children:
(Ex: Mary Jones and John Smith, etc.)
Number of grandchildren, great-grandchildren, etc:
(Ex: five grandchildren and two great-grandchildren)
Mailing instructions:
