Bride's First Name:		Bride's Last Name:
	Groom's First Name:		Groom's Last Name:
	Street Address:		City:
	State:		Zip:
	Telephone Number:		Cell Number:
	E-mail Address:
	Requested Day/Date of Ceremony*:	MonthAprilMay June July August September October Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 06 07 08 09 10
	Requested Time of Ceremony:	Time 10:00am 10:30am 11:00am 11:30am Noon 12:30pm 1:00pm 1:30pm 2:00pm 2:30pm 3:00pm 3:30pm 4:00pm 4:30pm 5:00pm 5:30pm 6:00pm
	*Chapel is open from Aptil 15 through the last weekend in October.
	Expected number of guests:
	Specify additional requests here:
	How did you hear about us?
Reservations are not final until you receive confirmation from Dells Bells Wedding Chapel. Sales tax not included. 50% Deposit due at time of booking. Remaining balance paid in cash or credit on day of ceremony. Deposits are non-refundable and are valid for a period of one year.