Laj -- Registration Form

Phone: +44 (0) 1753 538 508
Email: info@laj.co.uk


General	Advertisements	Registration	Sample Members	Fri May, 15:10:05

Registration

FORM REQUIRMENTS

Please complete the form below as accurately as possible (either by hand or type in your details), then send it along with the appropriate fee by cheque or postal orders payable to: Laj Marriage Bureau. You must sign and date this form at the end as stated.

Only when both this registration form and the fee have been received by this office will the 18 months period begin and introductions start. Please also send, if possible, your recent photograph, passport size or larger. Photographs are for office records only and will be returned as and when required by the members.

PLEASE FILL IN THIS FORM WITH CAPITAL LETTERS
Fields in bold (with *) are compulsory.

Laj Marriage Bureau International
Registration Form (Confidential)

APPLICANT'S PARTICULARS

Title:* (Mr/Mrs/Miss/Ms/Dr):		Surname:*

Gender:*		Forename(s):*
Email Address:*

Home/Residential Address:*		Job/Self Employment Address:



Post/Zip Code:*		Post/Zip Code:
Phone No:*		Phone No:
Can We Contact:*	Yes No	Can We Contact:	Yes No

Date of birth:*		Nationality:*
Height:*		Weight:
Complexion:*		General State Of Health:
Any Physical Defects:

Religion:*		Caste:
Country Of Birth:*		Marital Status:*

Any children (with sex and ages) and in whoes custody:*

Education, with special qualifications, if any (say 'School Standard' if none):*

Occupation:*

Income:		Do you drink?:*	Yes No
Do you smoke?:*	Yes No	Do you own a vehicle?:	Yes No
Are you vegetarian?:*	Yes No	Do you own property?:	Yes No

Where did you
hear about
Laj Marriage Bureau?

Please Specify

APPICANT'S FAMILY PARTICULARS

Father's name		Alive:* Yes: No:
Mother's name		Alive:* Yes: No:
How many do you have?	Brothers:*	Sisters:*
How many unmarried?	Brothers:*	Sisters:*

DESIRED PARTNER YOU WISH TO MEET

Age range:*		Height range:*
Religion:*		Caste:
Nationality:*

Would you accept a:	Widow:*		Widower:*
	Divorced:*		Separated Partner:*

With or without children:
Anything special you may like to mention:

DECLARATION BY APPLICANT/PARENTS, ETC

I declare that to the best of my knowledge and belief, the particulars given above are true.
I have read and understood the Terms and Conditions and will abide by them.
If you do not accept these terms and conditions, you should not join as a member.

Personal Two Fee Service (18 months)		I will send the registarion fee of £275. I also undertake to pay £150 as Marriage Settlment Fee within 7 days of Registration of Marriage.
Personal One Fee Service (18 months)		I will send the registarion fee of £325. I owe nothing after the marriage as there is no marriage settlement fee.

I understand that all the fees made above are neither refundable nor transferable.

Todays Date
Signed (Must be your name singed by hand)
Full name and relationship if signed by other than the Applicant
Cheque/Postal Orders should be made payable to: LAJ MARRIAGE BUREAU	Cash should be sent only by Registered Post to: LAJ MARRIAGE BUREAU, 137 Goodman Park, Slough, Berkshire, SL2 5NR, England.

Terms And

Conditions

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General	Advertisements	Registration	Sample Members	Fri May, 15:10:05