APPLICATION FOR MARRIAGE

Full Legal Name: ______Hebrew Name: ______Kohen: ___ Levi: ___ Israel: ___ Home Address: ______City: ______State: ______Zip: ______Work Name & Address: ______Home Phone: (_____) ______-______Cell: (_____) ______-______Work: (_____) ______-______Ext. ____ Email: ______Date of Birth: ____ /____ /______Place of Birth:______License or Passport #: ______Father’s Hebrew Name: ______Nicknames: ______Father’s Name used when signing documents: ______Mother’s Name: ______Was she born to a Jewish mother? Yes / No Was she or any of her maternal ancestors converted to Judaism? Yes / No If yes, which Beth Din was she or they converted? ______Home address of Father: ______Home Phone: (_____) ______-______Cell: (_____) ______-______Home address of Mother: ______Home Phone: (_____) ______-______Cell: (_____) ______-______Father’s Occupation: ______Mother’s Occupation: ______Names of Brothers & Sisters: ______Phone #’s: ______MARITAL HISTORY: Were you previously married? Yes / No If yes, how many times? ______Was a get issued at the termination of the marriage(s)? Yes / No If yes, which Beth Din issued the get : ______Children from previous marriage(s): ______Date of your parent’s marriage: ___ / ___ / _____ In Which City: ______Were either of your parents divorced? Yes / No Was a get issued? Yes / No Beth Din that issued the get : ______Has either of them remarried at this time? Yes / No Were you adopted? Yes / No Were either of your parents adopted? Yes / No Were you, your parents, or your grandparents converted to Judaism? Yes / No If converted, by whom? ______From what religion? ______Are you or your parents still affiliated with the former religion? Yes / No Present Synagogue affiliation: ______DOCUMENTS NEEDED

1. Copy of your Birth Certificate.

2. Copy of the Ketubah of your parents.

3. Provide two names and phone numbers of individuals who know your parents from childhood

who can vouch for your Jewish roots:

Name: ______Phone: (_____) ______-______

Name: ______Phone: (_____) ______-______

4. Provide a letter from each of the two individuals explaining how they know you and how they

can verify that you are Jewish.

5. Provide a letter signed by a friend verifying that each of you are currently single and have not

been married in the past.

6. A copy of “Get”& divorce papers or death certificate if previously married.

7. Please confirm that all food at the wedding will be certified kosher.

8. Groom should purchase a wedding band from his own money and it should not have any

markings on it.

9. Bride should contact Shulamit Konikov 321-693-7706 to schedule & prepare for Mikvah.

The Rabbi will meet with the bride and groom to review their wedding plans and the ceremony procedures. The Ketubah and witnesses will be arranged by the Rabbi.

Contact Rabbi Konikov if you have any questions. [email protected]

Other Items that will be needed:

Secure Chupa canopy

Small table to be set up under or near Chupa

Prepare a list of names for honors & blessings under Chupa (6 blessings available, additional 4 can be honored with holding canopy poles)

4 Ounce Glass Cup - no stem (thin glass)

White wine bearing OU or OK - states Mevushal

Thick paper bag or thick aluminum foil to wrap glass for breaking.

Candles, Matches, Lantern to cover flame from wind to be held by escorts of bride & groom walking towards chupah & circling.

Ask Rabbi for track of Alter Rebbe's melody traditionally played at Chabad weddings - while this is a beautiful custom it is not mandatory

YICHUD ROOM

Arrange with hotel for a private room with no windows or doors leading to adjoining rooms.