Re-Marriage Application Form On the occasion of Christmas Puja, Ganapatipule, 2014 Please fill out form in full. If details are not complete, your application may not be accepted. Fill out in duplicate (x2). Coordinators to retain a copy for future reference. (Only submit one application form per Married Couple) This application is for married couples who would like to receive the blessing of a Sahaja Marriage. Please confirm that you are already legally married by providing the date and place of your wedding as well as any other details and documents (Enclose a copy of Marriage Registration certificate if the marriage is registered). Date of marriage: DD/MM/YYYY Marriage took place in which City/State/Country: Any other details you may like to provide: What is the purpose of this re-marriage? Will you both be coming to Ganapatipule for Christmas Puja? For Husband: Title: Surname: Passport no: YES/ NO First Name: Date of Birth: Please affix color passport type photograph on each copy Email: DD/MM/YYYY Husband’s signature: Date: Signature DD/MM/YYYY For Wife: Title: Surname: Passport no: First Name: Date of Birth: Please affix color passport type photograph on each copy Email: DD/MM/YYYY Wife’s signature: Date: Signature DD/MM/YYYY Home Address: Flat/Plot no: Building Name: Town/City: Phone no: Include Area Code Street/Road: State: Pin code/Zip Code: E mail: Signature of Centre/City/State/Country coordinator I certify this person’s application FULL NAME Signature Date: Phone Number: Email:________________________________________ Country:
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