Section 1 of 10
ISWMD Nikāḥ Ceremony Request Form
As salāmu ʿalaykum wa raḥmatullāhi wa barakātuh
Jazakumullāhu khayran for choosing the Islamic Society of Western Maryland (ISWMD) for your Nikāḥ ceremony.
Please complete the form below so that we can gather the necessary information and coordinate a suitable date and time for your Nikāḥ.
Please note: Submitting this form is a request for a Nikāḥ appointment and does not confirm the date or time. A member of the masjid will contact you to confirm the appointment and any required documentation.
Section 2 of 10
Groom's Information
Groom's Full Legal Name
Groom's Full Legal Name
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Groom's Phone Number
Groom's Phone Number
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Groom's Email Address
Groom's Email Address
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Groom's Date of Birth
Groom's Date of Birth
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Groom's Current Address
Groom's Current Address
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Section 3 of 10
Bride's Information
Bride's Full Legal Name
Bride's Full Legal Name
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Bride's Phone Number
Bride's Phone Number
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Bride's Email Address
Bride's Email Address
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Bride's Date of Birth
Bride's Date of Birth
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Bride's Current Address
Bride's Current Address
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Section 4 of 10
Wali & Witnesses
Will the Bride's Wali (Gurdian) be present at the Nikāḥ?
Will the Bride's Wali (Gurdian) be present at the Nikāḥ?
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Yes
No
Not Sure
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If yes, what is the wali's full name?
If yes, what is the wali's full name?
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Wali's Relationship to the Bride
Wali's Relationship to the Bride
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Father
Son
Brother
Paternal Uncle
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Do you have two witnesses available for the Nikāḥ?
Do you have two witnesses available for the Nikāḥ?
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Witnesses' Names
Witnesses' Names
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Section 5 of 10
Marriage & Nikāḥ Information
Is this the first marriage for both the bride and groom?
Is this the first marriage for both the bride and groom?
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Yes
Yes, For The Bride Only
Yes, For The Groom Only
No
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If either party was previously married, has the previous marriage ended?
If either party was previously married, has the previous marriage ended?
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Have you obtained your civil marriage license?
Have you obtained your civil marriage license?
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Not Yet
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What is the agreed Mahr?
What is the agreed Mahr?
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Please state the amount and/or items agreed upon as Mahr.
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Section 6 of 10
Preferred Nikāḥ Date & Time
Preferred Nikāḥ Date
Preferred Nikāḥ Date
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Preferred Nikāḥ Time
Preferred Nikāḥ Time
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Do you have an alternative date if your first preference is unavailable?
Do you have an alternative date if your first preference is unavailable?
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Do you have any special requests or arrangements for the Nikāḥ ceremony?
Do you have any special requests or arrangements for the Nikāḥ ceremony?
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Section 7 of 10
Nikāḥ Fee / Contribution
Nikāḥ Ceremony Contribution
The suggested fee for the Nikāḥ ceremony is $250, which helps compensate the Imam for his time and services.
If you are unable to pay the suggested fee, please do not let this prevent you from requesting a Nikāḥ at ISWMD.
Suggested Nikāḥ Contribution
Suggested Nikāḥ Contribution
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I would like to contribute the suggested amount of $250
I would like to contribute a different amount
I am unable to contribute at this time
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If you selected "a different amount," please enter the amount.
If you selected "a different amount," please enter the amount.
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Section 8 of 10
Documentation & Requirements
Groom'd ID
Groom'd ID
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Add file
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Bride's ID
Bride's ID
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Add file
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Who should the masjid contact regarding the Nikāḥ?
Who should the masjid contact regarding the Nikāḥ?
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Bride
Groom
Other:
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Preferred Method of Contact
Preferred Method of Contact
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Section 9 of 10
Acknowledgment
Please confirm the following:
Please confirm the following:
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I understand that submitting this form is a request for a Nikāḥ appointment and does not confirm the date or time.
I confirm that the information provided in this form is accurate to the best of my knowledge.
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Section 10 of 10
Confirmation Message
Jazākumullāhu khayran for submitting your Nikāḥ request.
The ISWMD team will review your information and contact you regarding the requested date and time.
Please note that your Nikāḥ date and time are not confirmed until you receive confirmation from the masjid.
May Allah ﷻ bless your marriage and grant you both a life filled with love, mercy, and barakah. Āmīn.
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