Online Marriage Form

Applicant 1 Personal Information
Name:
First Middle Last Suffix
Last Name At Birth (if different):
Gender (optional):
Street Address:
City:
State, Zip:
,
County Residing:
Select a NC county or fill in one
   Or   
Inside City Limits of City?
 
Date of Birth:
Age:
Birthplace County/State:
Select a NC county or fill in one
   Or   
State
 
Race (optional):
Present
Not Present

Applicant 1 Marital History
Which marriage is this?
Last Marriage Ended Date:
Last Marriage Ended Reason:

Applicant 1 Educational Information
What is the highest grade completed?
Elementary High School College

Applicant 1 Parental Information
Parent 1 Full Name:
(Include name at birth if different.)
Address: (Street, City)
State:
Parent 1 Birthplace State:
Parent 2 Name:
(Include name at birth if different.)
Address: (Street, City)
Same as Parent 1
State:
Parent 2 Birthplace State:
* If Name or Address is not known, please type UNKNOWN in that field *
Applicant 2 Personal Information
Name:
First Middle Last Suffix
Last Name At Birth (if different):
Gender (optional):
Street Address:
Address same as Applicant 1
City:
State, Zip:
,
County Residing:
Select a NC county or fill in one
   Or   
Inside City Limits of City?
 
Date of Birth:
Age:
Birthplace County/State:
Select a NC county or fill in one
   Or   
State
 
Race (optional):
Present
Not Present

Applicant 2 Marital Information
Which marriage is this?
Last Marriage Ended Date:
Last Marriage Ended Reason:

Applicant 2 Educational Information
What is the highest grade completed?
Elementary High School College

Applicant 2 Parental Information
Parent 1 Full Name:
(Include name at birth if different.)
Address: (Street, City)
State:
Parent 1 Birthplace State:
 
Parent 2 Name:
(Include name at birth if different.)
Address: (Street, City)
Same as Parent 1
State:
Parent 2 Birthplace State:
* If Name or Address is not known, please type UNKNOWN in that field *