This form is to be completed and sent to the Bishop by the member of theClergy who desires to solemnize the marriage of the Petitioner TheBishop is to be allowed 30 days in which to reply and the marriage cannotbe scheduled until his writtenapproval is received.

 I hereby certify: that I have investigated the divorce decree(s) and find it (them) to be both legal and final; and that in my judgment concerning the previous marriage(s), no marriage bond, as at is recognized by the Church, now exists. Furthermore, I have examined, counseled and instructed the parties in the nature, meaning and purpose of Holy Matrimony and in all other ways have conformed to Title I, Canons 18 and 19 of The Episcopal Church.

 Therefore, being convinced the parties understand that "he union of husband and wife, in heart, body and mind, is intended by God for their mutual joy; for the help and comfort given one another in prosperity and adversity; and when it is Godís will, for the procreation of children and their nurture in the knowledge and love of the Lord," and that the parties will do their utmost to maintain this sacred relationship and "to seek Godís help thereto", I seek your permission to solemnize the marriage between the parties named herein.
 
 

_________________________________
Clergy Signature
 

________________________
Date

St. Maryís, Shelter Island
Parish

To be Completed by Applicant

APPLICANT (Complete this section)

Name:______________________________________
 
Address:_____________________________________

City/State/Zip:________________________________

Religious Affiliation:___________________________

 Parish:____________________________________

Date decree(s) became final:___________________

 Number of this marriage:_______________________

 INTENDED SPOUSE:

 Name:_____________________________________

 Address:____________________________________

 City/Stale/Zip:_______________________________

 Religious Affiliation:__________________________

 Parish:____________________________________

 Dale decree(s) became final:____________________

 Number of this marriage:________________________

 State the grounds for the Divorce:___________________________________________________________________________________________________________________
 
 
 

Clergy Section

If the petitioner is not a member of your parish, please state the reasons you desire to solemnize the marriage (use additional sheet if necessazy)_____________
_____________________________________________________________________________________________________________________________
 

In the name of the Father, and of the Son, and of the Holy Spirit. Amen. 
 

 Declaration of Intention


We,
_______________________________

 and
_______________________________

desiring to receive the blessing of Holy Matrimony In the Church, do solemnly declare that we hold marriage to be a lifelong union of husband and wife as is set forth in the liturgical forms authorized by this Church.

 We believe it is for the purpose of mutual fellowship, encouragement, and understanding. for the procreation (If It may be) of children, and their physical and spiritual nurture, and for the safeguarding and benefit of society, and we do engage ourselves, so far as in us lies to make our utmost effort to establish this relationship.and to seek God's help thereto.
 
 

 _______________________________
Signature of Groom.
 

_______________________________
Signiature of Bride (Maiden Name)
 
Dated _________________________________A.D.__________________

The intended marriage is tentatively proposed for:________________________