Name:                                                                  Age:

Address:

City: State: Zip:

Email:

How long have you and your partner been together?

Is this your first committed relationship (gay or not)?

Have you had a prior marriage?

Date of Dissolution or Final Divorce Decree:

Are you a member of MCC Austin?

Signature Date

Name: Age:

Address:

City: State: Zip:

Home Phone: Alternate Phone:

Email:

How long have you and your partner been together?

Is this your first committed relationship (gay or not)?

Have you had a prior marriage?

Date of Dissolution or Final Divorce Decree:

Are you a member of MCC Austin?

Signature Date

Application For Rite of Marriage