Marriage Intake Questionnaire

Congratulations on your engagement. We will contact you to schedule your first meeting about preparing for the Sacrament of Matrimony.

General Questions

What is the name of the church, city and state you plan on getting married? REQUIRED Please fill out this field. Please enter valid data.

What is the name of the church, city, and state you plan to be prepared for marrage? REQUIRED Please fill out this field. Please enter valid data.

Do you have a date in mind? REQUIRED Yes No Please fill out this field.

If yes, when? REQUIRED Please fill out this field. Please enter valid data.

Are you currently married civilly? REQUIRED Yes No Please fill out this field.

Are you a registered parishioner of St. Theresa? REQUIRED The bride is a registered parishioner. The groom is a registered parishioner. Neither is a registered parishioner. Please fill out this field.

Would you like your wedding to take place in the context of a full Mass? REQUIRED Yes No Not sure Please fill out this field.

Groom's Information

Groom's Full Legal Name (first, middle and last name on your birth certificate) REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Has the Groom been married before? REQUIRED Yes No Please fill out this field.

If Yes, was the marriage Annulled? Yes No

What is the groom's current religious affiliation? REQUIRED Please fill out this field. Please enter valid data.

Is the groom a baptized Catholic? REQUIRED Yes No Baptized in another Christian Faith Please fill out this field.

If baptized, please list the church and city/state of your baptism. Please enter valid data.

Has the groom received First Eucharist? REQUIRED Yes No Please fill out this field.

If yes, please list the church and city/state of your First Eucharist. Please enter valid data.

Has the groom received the Sacrament of Confirmation? REQUIRED Yes No Please fill out this field.

If yes, please list the church and city/state of your Confirmation. Please enter valid data.

Bride's Information

Bride's Full Legal MAIDEN Name (first, middle and last name on your birth certificate) REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Has the Bride been married before? REQUIRED Yes No Please fill out this field.

If Yes, was the marriage Annulled? Yes No

What is the bride's current religious affiliation? REQUIRED Please fill out this field. Please enter valid data.

Is the bride a baptized Catholic? REQUIRED Yes No Baptized in another Christian Faith Please fill out this field.

If baptized, please list the church and city/state of your baptism. Please enter valid data.

Has the bride received First Eucharist? REQUIRED Yes No Please fill out this field.

If yes, please list the church and city/state of your First Eucharist. Please enter valid data.

Has the bride received the Sacrament of Confirmation? REQUIRED Yes No Please fill out this field.

If yes, please list the church and city/state of your Confirmation. Please enter valid data.