Your Name *

First Name

Last Name

Phone *

(###)

###

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Bride's Name *

First Name

Last Name

Groom's Name *

First Name

Last Name

Is this an interfaith ceremony? *

Note: we only officiate interfaith ceremonies between a Muslim groom with a bride who practices an Abrahamic faith (Jewish or Christian)

Yes

No

Ceremony Date *

MM

DD

YYYY

Ceremony Venue *

Note: we only officiate ceremonies within the United States

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

How would you like the officiant to dress? *

Western Formal

Islamic Traditional

Officiant's Choice