Personal Information

Partner A's Name:

Street Address:

City, State, Zip

Birthdate:

Best Phone Number:

Email:

Occupation:

Religious Affiliation:

Partner B's Name:

Street Address:

City, State, Zip

Birthdate:

Best Phone Number:

Email:

Occupation:

Religious Affiliation:

Ceremony Details

Wedding or Renewal of Vows?

Ceremony Date:

Ceremony Time:

Ceremony Location:

Rehearsal Date:

Rehearsal Time:

Number of Guests Expected:

Ceremony Director:

License obtained yet?

How did you hear of us?

Comments? Requests? Feel free to note them here

If you have already contacted Dr. Leininger and learned that he is available to officiate on the date and at the time you are requesting and you would like to remit your deposit via PayPal, that is perfectly acceptable. Click on the PAY NOW button below, fill in the appropriate amount, submit it, and we will get you on the calendar. Failure to pay the deposit within fourteen days of the initial arrangements will automatically cancel the agreement. Deposits are 100% refundable up to 60 days prior to the reserved date.