Diocese of Springfield in Illinois

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

This page will walk you through the process of registering for your FOCCUS Pre-Marriage Inventory questionnaire, including the payment of your fee. Once you have completed all the necessary information, you will be sent your user id and password so that you can go online and complete your FOCCUS Pre-Marriage inventory. Only one registration is needed per couple.

Qty

Description

Amount

Total

FOCCUS Marriage Inventory

$20.00

Would you like to receive our e-newsletter to receive updates on upcoming events, marriage and family tips and major diocesan announcements?

Updates:

Groom’s Registration Information

First Name: *

Middle Name:

Last Name: *

Initials: *

(first letter of first, middle and last names)

Street Address: *

City: *

State: *

Zip Code: *

Phone Number: *

Groom's Email Address: *

Groom’s email address cannot be the same as the bride’s email address

Religion: *

Bride’s Registration Information

First Name: *

Middle Name:

Last Name: *

Initials: *

(first letter of first, middle and last names)

Street Address: *

City: *

State: *

Zip Code: *

Phone Number: *

Bride's Email Address: *

Bride’s email address cannot be the same as the groom’s email address

Religion: *

Wedding Date: *

Parish Name and City: *

Name of priest or deacon you are working with to prepare for Matrimony: *

Billing Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *

Name on Account: *

Routing Number: *

Account Number: *