Nikkah Request | Darus Salaam Center

Unique ID

Bridegroom Details

Bridegroom Name*

First Last

Bridegroom Date of Birth*

Age*

ID / Passport No.*

Was the bridegroom married previously?*

Yes

No

Where was nikkah made?*

Date of nikkah dissolving?*

How was nikkah dissolving?*

Bride Details, Representative and Witnesses

Bride Name*

First Last

Bride Date of Birth*

Age*

ID / Passport No.*

Was the bride married previously?*

Yes

No

Where was nikkah made?*

Date of nikkah dissolving?*

How was nikkah dissolving?*

Representative

Reprisentative Name*

First Last

Representative Date of Birth*

Age*

ID / Passport No.*

Witnesses

Witness 1 - Name*

First Last

Witness 1 - Date of Birth*

Age*

ID / Passport No.*

Witness 2 - Name*

First Last

Witness 2 - Date of Birth*

Age*

ID / Passport No.*

Date of Nikkah*

Time*

:

Mahr*

Applicate Details

Applicant Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Enter Email Confirm Email

Phone*

Cell Number*

Notice Board Information

Bridegroom: Son of*

First Last

Name of Bridegroom's father

Place*

Bride: Daughter of*

First Last

Name of Bride's father

Place*

Upload supporting Documents

Bridegroom ID / Passport*

Accepted file types: jpg, gif, png, pdf, Max. file size: 4 MB.

jpg, gif, png, pdf formate are only allowed.

Bride ID / Passport*

Accepted file types: jpg, gif, png, pdf, Max. file size: 4 MB.

jpg, gif, png, pdf formate are only allowed.

Comments

This field is for validation purposes and should be left unchanged.

النكاح من سنتي وقال فمن رغب عن سنتي فليس مني

Nikah Register Request

Bridegroom Details

Bride Details, Representative and Witnesses

Representative

Witnesses

Applicate Details

Notice Board Information

Upload supporting Documents