|
| Name * |
: |
|
| Email Address * |
|
|
| Phone |
: |
|
| Fax |
: |
|
| GROOM |
|
| Name * |
: |
|
| Nationality * |
: |
|
| Place & Date of Birth * |
: |
|
| Religion * |
: |
|
| Occupation * |
: |
|
| Local Address (in Bali) |
: |
|
| Permanent Address * |
: |
|
| Have / have not been married before |
: |
No
Yes |
| Name of ex-wife |
: |
|
| Children from previous marriage |
: |
|
|
| FATHER OF GROOM |
|
| Name * |
: |
|
| Age * |
: |
|
| Religion * |
: |
|
| Occupation * |
: |
|
| Permanent Address * |
: |
|
|
| MOTHER OF GROOM |
|
| Name * |
: |
|
| Age * |
: |
|
| Religion * |
: |
|
| Occupation * |
: |
|
| Permanent Address * |
: |
|
|
| BRIDE |
|
| Name * |
: |
|
| Nationality * |
: |
|
| Place & Date of Birth * |
: |
|
| Religion * |
: |
|
| Occupation * |
: |
|
| Local Address (in Bali) |
: |
|
| Permanent Address * |
: |
|
| Have / have not been married before |
: |
No
Yes |
| Name of ex-husband |
: |
|
| Children from previous marriage |
: |
|
|
| FATHER OF BRIDE |
|
| Name * |
: |
|
| Age * |
: |
|
| Religion * |
: |
|
| Occupation * |
: |
|
| Permanent Address * |
: |
|
|
| MOTHER OF BRIDE |
|
| Name * |
: |
|
| Age * |
: |
|
| Religion * |
: |
|
| Occupation * |
: |
|
| Permanent Address * |
: |
|
|
| FIRST WITNESS |
Witnesses may not be immediate family such as parents,
brothers or sisters. |
|
| Name |
: |
|
| Age |
: |
|
| Religion |
: |
|
| Occupation |
: |
|
| Permanent Address |
: |
|
|
| SECOND WITNESS |
Witnesses may not be immediate family such as parents,
brothers or sisters. |
|
| Name |
: |
|
| Age |
: |
|
| Religion |
: |
|
| Occupation |
: |
|
| Permanent Address |
: |
|
|
| Flight Details |
|
|
|
| PREFERRED PLACE & DATE OF WEDDING CEREMONY |
|
|
|
|
|
|
| |