Nikah Form

Name *

First

Last

Phone *

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Date of Event

Start Time:

Ending Time

Number of Men Expected *

Number of Women Expected

Reason for Event

Request for Imam to Perform Nikah

Groom’s Name

Groom's DOB

Groom’s Father Name

Bride’s Name

Bride's DOB

Bride’s Father Name

Mahar Amount (dowry):

Select all applicable

Two Male Witnesses

Name of Bride’s Representative (wali):

Relationship to Bride:

Date of Marriage License:

Location

Questions or comments: *

Initial

I 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 $500 to host the Nikah in the Masjid and a separate minimum honorarium ($250) to be paid to the Imam conducting the speech and/or Nikah (if any). 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.

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