|
Full
Name :
|
(required)
|
|
Email
Address :
|
(required)
|
|
Alternative
email contact :
|
|
|
Phone
:
|
(required)
|
|
Fax
:
|
|
|
Groom
|
|
Name
:
|
(required)
|
|
Nationality
:
|
(required)
|
|
Place
& Date of Birth :
|
(required)
|
|
Religion
:
|
(required)
|
|
Occupation
:
|
(required)
|
|
Local
Address (in Bali) :
|
|
|
Permanent
Address :
|
(required)
|
|
Have
/ have not been married before :
|
No
Yes
|
|
Name
of ex-wife :
|
|
|
Children
from previous marriage :
|
|
|
Father
of Groom
|
|
Name
:
|
(required)
|
|
Age
:
|
(required)
|
|
Religion
:
|
(required)
|
|
Occupation
:
|
(required)
|
|
Permanent
Address :
|
(required)
|
|
Mother
of Groom
|
|
Name
:
|
(required)
|
|
Age
:
|
(required)
|
|
Religion
:
|
(required)
|
|
Occupation
:
|
(required)
|
|
Permanent
Address :
|
(required)
|
|
Bride
|
|
Name
:
|
(required)
|
|
Nationality
:
|
(required)
|
|
Place
& Date of Birth :
|
(required)
|
|
Religion
:
|
(required)
|
|
Occupation
:
|
(required)
|
|
Local
Address (in Bali) :
|
|
|
Permanent
Address :
|
(required)
|
|
Have
/ have not been married before :
|
No
Yes
|
|
Name
of ex-husband :
|
|
|
Children
from previous marriage :
|
|
|
Father
of Bride
|
|
Name
:
|
(required)
|
|
Age
:
|
(required)
|
|
Religion
:
|
(required)
|
|
Occupation
:
|
(required)
|
|
Permanent
Address :
|
(required)
|
|
Mother
of Bride
|
|
Name
:
|
(required)
|
|
Age
:
|
(required)
|
|
Religion
:
|
(required)
|
|
Occupation
:
|
(required)
|
|
Permanent
Address :
|
(required)
|
|
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
|
|
Arrival
Date :
|
,
(required) |
|
Departure
Date :
|
,
(required) |
|
Arrival
Flight No. :
|
(required) |
|
Departure
Flight No. :
|
(required) |
|
Preferred
Place, Packages & Date of Wedding Ceremony
|
|
Bali
Hotel Wedding at :
|
Nikko
Bali Resort & Spa
|
|
Wedding
Packages :
|
|
|
Special
Request :
|
|
|
|
| |
|
|
REQUIRED
DOCUMENTS
- Copy of Details Page Of Passport (HIS / HERS / WITNESSES)
- Copy of Birth Certificate (HIS / HERS)
- Copy of Divorce / Death Certificate (if applicable) - (HIS
/ HERS)
- Copy of Baptism Certificate (HIS / HERS)
- Photographs of couple together (4 X 6 cm) 5 pieces
NOTE
:
- Additional items are required for Catholic couples,
and this information will be given upon request.
|
