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Wedding Information Intake Form

- Sacraments

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- Wedding Date Requested REQUIRED Please fill out this field. Please enter a date.
- Mass or Ceremony REQUIRED Please fill out this field.
- GROOM INFORMATION
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Parish Please enter valid data.
  
  Baptismal Church Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  * If other that St. Rose, need letter of permission from home parish.
  
  Parishioner of St. Rose? REQUIRED Please fill out this field.
  
  SRHS Graduate? REQUIRED Please fill out this field.
  
  Graduation Year: Please enter valid data.
  
  Previous Marriages REQUIRED No Yes Please fill out this field.
- BRIDE INFORMATION
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Birth Date REQUIRED Please fill out this field. Please enter a date.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Parish Please enter valid data.
  
  Baptismal Church Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  * If other that St. Rose, need letter of permission from home parish.
  
  Parishioner of St. Rose? REQUIRED Please fill out this field.
  
  SRHS Graduate? REQUIRED Please fill out this field.
  
  Graduation Year: Please enter valid data.
  
  Previous Marriages REQUIRED No Yes Please fill out this field.
Submit

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Church of St. Rose 603 Seventh Avenue Belmar, New Jersey 07719 T: (732) 681-0512 F: (732) 280-3107	OFFICE HOURS Mon-Friday 9:30 AM- 12 noon and 1 PM to 4 PM	MASS SCHEDULE Monday – Friday: 6:45 & 9:00 am Monday Evening Adoration: 7:00 pm Saturday: 5:00 pm Sunday: 7:00, 9:30, 11:30am & 5:00 pm Confessions: 4:00 – 4:50 pm Saturday
Diocese of Trenton	St. Rose Grammar School	St. Rose High School