Certificate Order

Weddings On Church Street

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Your Name
Mailing Address
City
State & Zip Code
Contact Phone #
Email Address:
Certificate In	English Spanish
Decorative Certificate All certificates $12.99 (Includes shipping & handling to US & Canada)	Wedding Certificate Renewal Family Certificate (Blank, To be signed by family) Family Certificate (Family names printed)
1. Full Name as it will appear on certificate
2. Full Name as it will appear on certificate
Event Date
Event Location (example: Grand Ballroom, St Regis Hotel)
Event City & State
For Family Certificate with printed names only. List all family members.
1. Parent Name
2. Parent Name
List all children's names

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