|
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 &
DATE OF WEDDING CEREMONY
|
|
|
|
|
| |
|
|
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.
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