Street Address___________________________________________________
City ______________________________________ State ___________ Zip ___________
FPB member ______ Other UU member ________
| Information About You | ||
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| Name_____________________________________________ Today's date ______________________ | ||
Street Address___________________________________________________ | ||
City ______________________________________ State ___________ Zip ___________ | ||
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| Your phone _________________________ Your fax_____________________________ | ||
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| Your email address: ____________________________________ | ||
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FPB member ______ Other UU member ________ | ||
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| Date
of Service _______________ Time ___________ Number
of People in Wedding ______________ | ||
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| FPB Minister requested: __________________________________________________ | ||
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| Will have outside minister (yes/no): ________ | ||
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| Name of minister ___________________________ Minister's phone ______________________ | ||
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| Enclosed is deposit check for $ ________________ | ||
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| Send the completed form to: | First
Parish Brewster Attention: Mary Dumont | |