Dream Applications | Brides with Disabilities

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Home
- Dreams
About
- Get Involved
Officiant
- Wedding Questionaire
FAQ's
Services

Dream Application

Brides First, Middle Initial & Last Name*

Add Partners Name

Brides Date of Birth*

Brides Address, City, State & Zipcode*

Brides Phone Number*

Brides Email Address*

Are you Under a Specialized Doctors Care and can you provide the Hospital, Doctor or Care teams name and number if needed?*

Does the Bride Suffer from?*

Autoimmune Disease(s)

Chronic Illness

Cancer

Does the Bride Work?*

Yes

No

If you work, add your Job Title & Description here*

What is your Dream Wedding?*

Date of Wedding?*

What Do You Need Help With?*

Wedding Planning / Coordinator

Officiate

Other Wedding Needs

Grooms First, Middle Initial and Last Name*

Add Partners Name Here

Grooms Date of Birth*

Grooms Address, City, State & Zipcode*

Grooms Phone Number*

Grooms Email Address*

Are you Under a Specialized Doctors Care and can you provide the Hospital, Doctor or Care Team if Needed?*

Does the Groom Suffer From?*

Autoimmune Diseases

Chronic Illness

Cancer

Does the Groom Work?*

Yes

No

If you work, add your Job Title & Description Here*

What is your Dream Wedding?*

Date of Wedding?*

What Do You Need Help With?*

Wedding Planning Coordinator

Officiate

Other Wedding Needs

Brides with Disabilities grants wedding and vow renewal Dreams in Northern California Only. Priority is given to couples facing Autoimmune Diseases, Chronic Illnesses & Cancer. Our Dreams are based on our available resources & the help our wonderful volunteers.

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Email address

info@brideswithdisabilities.com

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910-545-4827