Male Applicant

Groom

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First Name		Middle Name		Last Name		Title	Please select JR SR I II III IV V
Address		City		State	ALABAMA ALASKA AMERICAN SAMOA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FEDERATED STATES OF MICRONESIA FLORIDA GEORGIA GUAM HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARSHALL ISLANDS MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS OHIO OKLAHOMA OREGON PALAU PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING	County
					Inside City Limits
Birthdate		Birthplace (County & State)
Education	Please select Elementary School High School College	Years of Education		Race	Please select ------------------- AFRAM AFRICAN AFRICAN AMERICAN AFRO AMERICAN ALANAT ALASKIAN NATIVE AM INDIAN/BLACK AMERICAN CHINESE AMERICAN INDIAN AMIND ARABIAN ARABIC ARABIC/MUSULIN ASIAN ASIAN AMERICAN ASIAN INDIAN ASIAN/PACIFIC ISLAND ASIAN/VIETNAMESE ASIND BLACK BLACK/ASIAN BLACK/HISPANIC BLACK/PORTUGESE BLACK/PUERTO RICAN BLACK/WHITE BLK BRAZILIAN CAUCASIAN CHICA CHICANA CHIN CHINESE CHOM CUBA CUBAN CUBAN AMERICAN EAST INDIAN EGYPTIAN EGYPTIAN/AMERICAN EGYPTIAN/WHITE EL SALVADORIAN FILI FILIPINO GERMAN/IRISH/FILIPIN GERMAN/ITALIAN GREEK GUAM GUATEMALAN HAWAIIAN HINDU HISPANIC HISPANIC/BLACK HISPANIC/SPANISH HISPANIC/WHITE HONDURAN HUMAN HUNGARIAN INDIA INDIAN INDIAN ASIAN IRANIAN ISLAM ISRAELI/ITALIAN ISREAL ITALIAN JAPA JAPANESE JAPANESE/AMERICAN JORDAN JORDANIAN JORDENIAN KORE KOREAN KOREAN/AMERICAN LEBANESE LEBANON MALOTTO MEHERRIN INDIAN MEXAM MEXI MEXICAN MEXICAN AMERICAN MEXICAN/ITALIAN MEXICO MICRONESIAN MIDDLE EASTERN MOOR MOSLEM MULATTO MULTI/RACIAL MUSLIM NATHAW NATIVE AM/BLACK NATIVE AMERICAN NEGRO/LATINO OASI OPACIS ORIENTAL OSPHILA OTH OTHER PAC/ASIAN PACIFIC ISLANDER PAKISTAN PALESTINE PALESTINIAN PALISTINA PHILLIPINES POLYNESIAN PORTUGUESE PUERI PUERTO RICAN ROMANIAN SAMO SAMOAN SOUTH AMERICAN SPANISH SRI LANKAN SUDANESE SYRIAN THAI VIET VIETNAMESE WHITE WHITE/AMERICAN INDIAN WHITE/ASIAN WHITE/BLACK WHITE/BLACK/NATIVE AMERICAN WHITE/HISPANIC WHITE/PACIFIC ISLANDER WHITE/SOUTH KOREAN WHITE/SWEDISH
Number of This Marriage	Please select 1 2 3 4 5 6 7 8 9 10 11 12	If Previously Married
		Marriage Ended By	Please select Annulment Death Divorce	Marriage Ended On(month/year)

Father

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First Name		Middle Name		Last Name
Address(If deceased please specify)		City		State	Please select ALABAMA ALASKA AMERICAN SAMOA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FEDERATED STATES OF MICRONESIA FLORIDA GEORGIA GUAM HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARSHALL ISLANDS MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS OHIO OKLAHOMA OREGON PALAU PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING	Zip Code
Place of Birth

Mother

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First Name		Middle Name		Maiden Name (if different)
Address(If deceased please specify)		City		State	Please select ALABAMA ALASKA AMERICAN SAMOA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FEDERATED STATES OF MICRONESIA FLORIDA GEORGIA GUAM HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARSHALL ISLANDS MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS OHIO OKLAHOMA OREGON PALAU PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING	Zip Code
Place of Birth

Female Applicant

Bride

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First Name		Middle Name		Last Name
Maiden Name
Address		City		State	ALABAMA ALASKA AMERICAN SAMOA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FEDERATED STATES OF MICRONESIA FLORIDA GEORGIA GUAM HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARSHALL ISLANDS MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS OHIO OKLAHOMA OREGON PALAU PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING	County
					Inside City Limits
Birthdate		Birthplace (County & State)
Education	Please select Elementary School High School College	Years of Education		Race	Please select ------------------- AFRAM AFRICAN AFRICAN AMERICAN AFRO AMERICAN ALANAT ALASKIAN NATIVE AM INDIAN/BLACK AMERICAN CHINESE AMERICAN INDIAN AMIND ARABIAN ARABIC ARABIC/MUSULIN ASIAN ASIAN AMERICAN ASIAN INDIAN ASIAN/PACIFIC ISLAND ASIAN/VIETNAMESE ASIND BLACK BLACK/ASIAN BLACK/HISPANIC BLACK/PORTUGESE BLACK/PUERTO RICAN BLACK/WHITE BLK BRAZILIAN CAUCASIAN CHICA CHICANA CHIN CHINESE CHOM CUBA CUBAN CUBAN AMERICAN EAST INDIAN EGYPTIAN EGYPTIAN/AMERICAN EGYPTIAN/WHITE EL SALVADORIAN FILI FILIPINO GERMAN/IRISH/FILIPIN GERMAN/ITALIAN GREEK GUAM GUATEMALAN HAWAIIAN HINDU HISPANIC HISPANIC/BLACK HISPANIC/SPANISH HISPANIC/WHITE HONDURAN HUMAN HUNGARIAN INDIA INDIAN INDIAN ASIAN IRANIAN ISLAM ISRAELI/ITALIAN ISREAL ITALIAN JAPA JAPANESE JAPANESE/AMERICAN JORDAN JORDANIAN JORDENIAN KORE KOREAN KOREAN/AMERICAN LEBANESE LEBANON MALOTTO MEHERRIN INDIAN MEXAM MEXI MEXICAN MEXICAN AMERICAN MEXICAN/ITALIAN MEXICO MICRONESIAN MIDDLE EASTERN MOOR MOSLEM MULATTO MULTI/RACIAL MUSLIM NATHAW NATIVE AM/BLACK NATIVE AMERICAN NEGRO/LATINO OASI OPACIS ORIENTAL OSPHILA OTH OTHER PAC/ASIAN PACIFIC ISLANDER PAKISTAN PALESTINE PALESTINIAN PALISTINA PHILLIPINES POLYNESIAN PORTUGUESE PUERI PUERTO RICAN ROMANIAN SAMO SAMOAN SOUTH AMERICAN SPANISH SRI LANKAN SUDANESE SYRIAN THAI VIET VIETNAMESE WHITE WHITE/AMERICAN INDIAN WHITE/ASIAN WHITE/BLACK WHITE/BLACK/NATIVE AMERICAN WHITE/HISPANIC WHITE/PACIFIC ISLANDER WHITE/SOUTH KOREAN WHITE/SWEDISH
Number of This Marriage	Please select 1 2 3 4 5 6 7 8 9 10 11 12	If Previously Married
		Marriage Ended By	Please select Annulment Death Divorce	Marriage Ended On(month/year)

Father

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First Name		Middle Name		Last Name
Address(If deceased please specify)		City		State	Please select ALABAMA ALASKA AMERICAN SAMOA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FEDERATED STATES OF MICRONESIA FLORIDA GEORGIA GUAM HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARSHALL ISLANDS MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS OHIO OKLAHOMA OREGON PALAU PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING	Zip Code
Place  of Birth

Mother

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First Name		Middle Name		Maiden Name
Address(If deceased please specify)		City		State	Please select ALABAMA ALASKA AMERICAN SAMOA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE DISTRICT OF COLUMBIA FEDERATED STATES OF MICRONESIA FLORIDA GEORGIA GUAM HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARSHALL ISLANDS MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA NORTHERN MARIANA ISLANDS OHIO OKLAHOMA OREGON PALAU PENNSYLVANIA PUERTO RICO RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGIN ISLANDS VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING	Zip Code
Place of Birth

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