Bride's Name *

First Name

Last Name

Bride's Phone *

(###)

###

####

Groom's Name *

First Name

Last Name

Groom's Cell

(###)

###

####

Wedding Date *

MM

DD

YYYY

What Services are you interested in? *

Wedding Videography

Wedding Photography

Wedding Photography & Videography

Wedding Planner/Coordinator's Name

First Name

Last Name

Wedding Planner/ Coordinator's Number

(###)

###

####

Wedding Ceremony Location *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Wedding Reception Location (if different from ceremony location)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country