Weddings Performed PO Box 1504 Deer Park, Texas 77536 281.478.6126 Fax: 281.478.5044 www.WeddingsPerformed.com Information Form ========================================================= How May We Contact You? ========================================================= Father's Name:_________________ Mother’s Name:_________________ Work:_________________ Home:_________________ Pager:_________________ Mailing Address for us to send your Letter of Confirmation to: __________________________________ __________________________________ __________________________________ Child’s Name:_________________ Date of Birth:_________________ [ ]Male [ ]Female Age:____ Godparents:_________________ _________________ Religion:_________________ ========================================================= Where Will the Baptism Take Place? ========================================================= Date: Time of Ceremony: [ ] AM [ ]PM Location Address: [ ] Inside [ ] Outside Phone Number of Location: DIRECTIONS: Please include directions to the location of your baptism along with this form and your deposit if your ceremony will be performed at a Private Residence, an Apartment Complex, Condo, or Townhouse. Special Remarks: __________________________________ ___________________________________________________ ___________________________________________________ ___________________________________________________ We would love to know how you heard about us: ____________________________________________ ========================================================= Wedding Dates are Reserved After Your Deposit is Received We Cannot Hold a Date Without a Deposit! ========================================================= I have confirmed the availability and fee with your office and will be reserving to perform our ceremony. (check one) [ ]Minister Lynn Turner [ ]Minister James Turner [ ]Minister David R. Duke [ ]Minister Brian Engle [ ]Minister Luis Gomez [ ]Minister Roxana Gomez [ ]Minister Steve Green [ ]Minister David Johnson [ ]Minister Michelle Jenkins - Paulk [ ]Minister Frank Sipps [ ]Minister George Sutherland [ ]Minister LaVaughn Washington [ ]Minister Esthela Davila [ ]Minister Marc Sherman ========================================================= TO PAY BY CREDIT CARD ========================================================= I am enclosing my deposit of $ ____________ leaving a balance of $____________ due in CASH at the time of the ceremony. I look forward to receiving our "Letter of Confirmation" in the mail within the next few days! Name exactly as it appears on the Credit Card (Please Print) ____________________________________________________________ Billing Address EXACTLY as it appears on the Credit Card Statement: __________________________________ __________________________________ __________________________________ Card Type (check one) [ ]MasterCard [ ]Visa [ ]Discover [ ]American Express Card Number _ _ _ _ - _ _ _ _- _ _ _ _- _ _ _ _ Expires _ _ - _ _ Amount $____________________ ___________________________________________ Authorized Signature (c) 2003 All Rights Reserved- Weddings Performed