Marriage License Order Form

1. GROOM'S INFORMATION:

         First Name 
        Middle Name 
          Last Name 
   Suffix (Jr. etc.)
     Street Address 
    Address (cont.) 
               City 
             County 
     State/Province 
    Zip/Postal Code 
            Country 
         Work Phone 
         Home Phone 
         Cell Phone 
             E-mail 
   

2. This is my (1st, 2d, etc.) marriage:

   
    

3. Last marriage ended by (divorce, death, etc.):
   
    
    

4. Date ended:   (mm/dd/yy)
    

5. Please provide the following information:

      Date of Birth  (mm/dd/yy)
               Race White Black HispanicAsian Other
   

6. Enter your Social Security # in the space provided below:

     (format: 123-45-6789)
   
   

7. Birthplace (State or Country):

    
   

                                          

1. BRIDE'S INFORMATION:

         First Name 
        Middle Name 
          Last Name 
        Maiden Name 
     Street Address 
    Address (cont.) 
               City 
             County 
     State/Province 
    Zip/Postal Code 
            Country 
         Work Phone 
         Home Phone 
         Cell Phone 
             E-mail 
   

2. This is my (1st, 2nd, 3rd, etc.) marriage:

   
   

3. Last marriage ended by (divorce, death, etc.):
   
     
    

4. Date ended:   (mm/dd/yy)
    

5. Please provide the following information:

      Date of Birth  (mm/dd/yy)
               Race White Black HispanicAsian Other
   

6. Enter your Social Security # in the space provided below.

      (format: 123-45-6789)
   
   

7. Birthplace (State or Country):

    
   

   

    

Address and Telephone (after ceremony):

  Street Address 
 Address (cont.) 
            City 
  State/Province 
 Zip/Postal Code 
         Country 
      Home Phone 

Street address to send license by Federal Express (must be an office/work address):

  Street Address 
 Address (cont.) 
            City 
  State/Province 
 Zip/Postal Code 
         Country 
      Home Phone 

    Contact Name 

    Best time to call  AnytimeMorning - 9-12 nAfternoon 1-5 p.m.Evening 6-9 p.m.

    Wedding Date  (mm/dd/yy)

    Travel Date*  (mm/dd/yy)

* This is the date you will be leaving 

home to travel to Florida

Once you submit this form, we will contact you regarding payment information.**

** Important:  We provide this service for only $185, which includes the courthouse filing fee, an application fee, Federal Express delivery and long distance charges.  All major credit cards accepted.

All information provided will be kept strictly confidential.  Please see our privacy policy.

South Florida Event Professionals, Inc.

P.O. Box 18073

West Palm Beach, FL  33416

Cell:  (561) 308-0621

Evening:  (561) 966-3336

Fax:  (561) 963-0775