Our Lady of Fatima Retreat House

5353 East 56th Street

Indianapolis, IN 46226

(317) 545-7681

www.archindy.org/fatima

MARRIAGE PREPARATION PROGRAM INFORMATION SHEET

(All fields are mandatory to complete registration)

Primary Contact Information

First Name Click here to enter text.

Middle Name	Click here to enter text.

Last Name Click here to enter text.

Address	Click here to enter text.

City	Click here to enter text.

State	Click here to enter text.

Zip	Click here to enter text.

Telephone	Click here to enter text.

Email Address	Click here to enter text.

Wedding Information

Denomination

Click here to enter text.

Wedding Date

Click here to enter text.

Wedding Church

Click here to enter text.

His & Her Personal Information

Your Personal Information

First Name Click here to enter text.

Middle Name	Click here to enter text.

Last Name Click here to enter text.

Birthdate	Click here to enter text.

Gender	Click here to enter text.

Address	Click here to enter text.

City	Click here to enter text.

State	Click here to enter text.

Zip	Click here to enter text.

Fiancés Personal Information

First Name Click here to enter text.

Middle Name	Click here to enter text.

Last Name Click here to enter text.

Birthdate	Click here to enter text.

Gender	Click here to enter text.

Address	Click here to enter text.

City	Click here to enter text.

State	Click here to enter text.

Zip	Click here to enter text.

PRE-CANA Marriage Prep Weekend Selection

Please number your first choice with ‘1’ and your second choice with ‘2’:

2017

____ Sept 22-23, 2017

____ Oct 13-14, 2017

____ Dec 1-2, 2017