Who is completing this form?

Bride

Groom

Other

Your Name *

First Name

Last Name

Your Preferred Phone Number

(###)

###

####

Your Preferred Contact Method

Email

Phone

Is someone in either family a member of WHPC?

Yes

No

If Yes, who:

Bride

Groom

Bride Parent

Groom Parent

Full name of WHPC Member

First Name

Last Name

Bride's Name

First Name

Last Name

Bride's Date of Birth

MM

DD

YYYY

Bride's Phone Number

(###)

###

####

Groom's Name

First Name

Last Name

Groom's Date of Birth

MM

DD

YYYY

Groom's Phone Number

(###)

###

####

Requested Wedding Date/Time

MM

DD

YYYY

Hour

Minute

Second

AM PM

Alternate Date/Time Request

MM

DD

YYYY

Hour

Minute

Second

AM PM

Preferred Wedding Location

Sanctuary (max 800)

Chapel (max 100)

Undecided