Nikah Form Name *FirstLastPhone *Email *AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDate of EventStart Time:Ending TimeNumber of Men Expected *Number of Women ExpectedReason for EventRequest for Imam to Perform NikahGroom’s NameGroom's DOBGroom’s Father NameBride’s NameBride's DOBBride’s Father NameMahar Amount (dowry):Select all applicableDon’t DiscloseTwo Male WitnessesName of Bride’s Representative (wali):Relationship to Bride:Date of Marriage License:LocationQuestions or comments: *InitialI acknowledge: Masjid Hamza offers a wide array of programs and services that may make the Masjid unavailable to host this event. I am not guaranteed the date and time I have requested for the Nikah. After I have received confirmation from Masjid Hamza then I may inform my guest of the event. There is a Masjid fee of $200 to host over 20 individuals (free if it's under 20) and a separate minimum honorarium ($200) to be paid to the Imam conducting the speech and/or Nikah (if any). In addition, if chai (tea) is needed, there is an additional cost of $40 per 4-gallon container. These fees will be collected prior to the event. Due to limited space and resources Masjid Hamza has to offer, requests to serve food will be discussed upon approval of the event. You will receive a response within 2-3 business days.MessageSubmit