 Your Contact Details
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| Your Name |
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| Postal Address |
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| Email Address |
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| Telephone |
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| Fax |
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| Groom |
| Name |
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| Nationality |
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| Place & Date of Birth |
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| Religion |
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| Occupation |
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| Local Address (in Bali) |
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| Permanent Address |
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| Have been married previously |
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No Yes |
| If yes, name of ex-wife |
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| Children from previous marriage |
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Father of Groom |
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| Name |
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| Age |
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| Religion |
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| Occupation |
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| Permanent Address |
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| Mother of Groom |
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| Name |
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| Age |
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| Religion |
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| Occupation |
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| Permanent Address |
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| Bride |
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| Name |
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| Nationality |
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| Place & Date of Birth |
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| Religion |
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| Occupation |
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| Local Address (in Bali) |
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| Permanent Address |
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| Have you been married previously |
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No
Yes |
| If Yes, name of ex-husband |
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| Children from previous marriage |
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| Father of Bride |
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| Name |
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| Age | |
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| Religion |
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| Occupation |
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| Permanent Address |
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| Mother of Bride |
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| Name |
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| Age |
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| Religion |
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| Occupation |
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| Permanent Address |
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| First Witness |
| Important: Please note that the witnesses cannot be related to you. |
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| Name |
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| Age |
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| Religion |
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| Occupation |
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| Permanent Address |
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| Second Witness |
| Important: Please note that the witnesses cannot be related to you. |
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| Name |
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| Age |
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| Religion |
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| Occupation |
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| Permanent Address |
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| Place & Date of Ceremony |
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| Preferred Date of Wedding |
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| Preferred Place of Wedding |
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| Flight Details |
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| Arrival Date |
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| Flight No. |
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| Departure Date | |
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| Flight No. |
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| Which package are you interested in ? |
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| Romantic Vow Renewal $495 |
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Frangipani Romantic Wedding $1495 |
| Champagne Romantic Wedding $525 |
White Rose Romantic Wedding $1995 |
| Heliconia Romantic Wedding $995 |
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| Which location are you interested in ? |
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| Private Villa |
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Church or Chappel |
| Hotel or Resort |
Restaurant |
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| What kind of officiant would you like ? |
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| Balinese |
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Catholic |
| Christian |
Moslem |
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| Are you interested in any of the following ? |
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| Additional Bouquets |
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Limousine |
| Additional Leis |
Dove Release |
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Activity Planning |
Hair/Make-up |
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Cake |
Additional Photography |
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Catering |
Video |
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| How would you prefer to be contacted ? |
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Daytime Phone |
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E-mail |
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Evening Phone |
Fax |
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Please write any comments you may have in the box below:
Submitting this form entails no obligation whatsoever.
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| Required Document |
- Copy of Details Page of Passport for Bridge, Groom & Witnesses
- Copy of Birth Certificate Bride & Groom
- Copy of Divorce / Death Certificate (if applicable)
- Copy of Baptism Certificate for Bride & Groom
- Five (5) photographs of couple together (passport size taken horizontally)
NOTE: These photos will be used on your marriage certificate, groom must wear shirt with collar and bride must not have exposed shoulders.
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