EmailMe Form - Marriage Registry Form

Name *

First Last

Intended Spouse's Name *

First Last

Date of Proposed Wedding *

DD / MM / YYYY

Location and address of Wedding *

Please provide the full address, including suburb and postcode, not just the venue name (e.g. “123 Example Rd, Caulfield South VIC 3162”).

Name of Officiating Rabbi *

Email of officiating Rabbi *

Please note that a copy of this application will be sent to your officiating Rabbi.
If you would not like this to be sent please email: registrar@mbd.net.au

Your Home Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Your Email address *

Intended Spouse's Email *

Phone

Place of Birth

Please enter the Town and Country - eg. Melbourne, Australia

Date of Birth

DD / MM / YYYY

Gender

Male

Female

Are you a ... *

Cohen

Levi

Yisrael

Don't know

Hebrew or Jewish name (If unsure please indicate) *

Occupation

How long have you lived in Australia?

Answer in Years, Months. If born here, please write Whole Life

Has a family member previously applied using the Melbourne Beth Din marriage registry?

Yes

No

Unsure

Name of family member who previously applied

Please specify your relationship to the above-named family member:

Were you born Jewish? ie Was your mother halachically Jewish at the time of your birth? *

Yes

No

Don't know

Are you currently in the process of converting to Judaism

Yes

No

Have you completed a conversion to Judaism?

Yes

No

Date conversion was completed

DD / MM / YYYY

Which Beth Din is supervising this conversion?

Town and Country of conversion

Which Beth Din completed this conversion?

Were you adopted?

Yes

No

Was a Beth Din involved with your adoption?

Yes

No

Town and Country

Write Town, Country eg, London, England

Name of Beth Din involved in the adoption

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