EmailMe Form - Diocese of Madison NFP Pre-Registration

EmailMeForm

Information Everyone Should Fill Out
Regardless of your marital status, please fill out the information for the woman's name and contact information.
Marital Status
Engaged
Married
Single (not engaged)
Name of Parish
City (of parish) *
Zip Code (of parish) *
Who referred you to us (Church, marriage prep, physician, media)? *
Woman's Name *
First Last
Woman's Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Woman's Email *
Woman's Phone Number *
### - ### - ####
Married & Engaged
If you are married or engaged, please fill in the information below concerning the man's contact information and your wedding.
Man's Name
First Last
Man's Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Man's Email
Man's Phone Number
### - ### - ####
Your Wedding Date
MM / DD / YYYY
Wedding Location (Name of Parish)
Are you required to take NFP for Marriage Preparation?
Yes - this is required
No - not required
Submit the Form Below
Fill out the CAPTCHA by typing into the white box the numbers and letters you see in the blue box. The letters are case sensitive. If you can't read the letters and numbers clearly, click the refresh button.

Then click the "Send Form" button below.

Again, when you submit this form, you will be taken to a page with more information about registering for the specific method you have chosen.
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Information Everyone Should Fill Out

Married & Engaged

Submit the Form Below