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									                     DENISE ILITCH DESIGNS
              MICHIGAN MILITARY BRIDE APPLICATION


APPLICANT MUST PRESENT VALID IDENTIFICATION TO VERIFY
MICHIGAN RESIDENCY.

BASIC INFORMATION:

BRIDES NAME: _______________________________________________

GROOMS NAME: ______________________________________________

BRIDES DATE OF BIRTH:
_________________________________________

GROOM’S DATE OF BIRTH:
_______________________________________

BRIDES AGE: ______________________

GROOMS AGE: _____________________

ADDRESS:

________________________________________________________

_______________________________

________________________________________________________


PHONE: ______________________                EMAIL:
_____________________

PLANNED DATE OF MARRIAGE:
___________________________________




MILITARY PERSONEL INFORMATION:

NAME: _____________________________________________________

SOCIAL SECURITY NUMBER:
____________________________________
MILITARY UNIT:
______________________________________________

ENTRY ON DUTY DATE:
__________________________________________

ON ACTIVE DUTY:     YES   ________      NO ______

IF NO, DATES ENLISTED:

START: ____________________ FINISH:
__________________________

IF YES,

CURRENTLY STATIONED AT:
_________________________

____________________________________________

_________________________

PLEASE REMIT COMPLETED APPLICATION TO:
MAIL:
DENISE ILITCH DESIGNS
ATTN: BROOKE LITES
2253 COLE STREET
BRIMINGHAM, MI 48009

FAX:
DENISE ILITCH DESIGNS
ATTN: BROOKE LITES
(248) 203- 7025

EMAIL:
BROOKE LITES
LITES.BROOKE@GMAIL.COM

PLEASE CALL BROOKE AT (248) 203-6789 FOR ANY FURTHER ASSISTANCE

								
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