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Wedding Reservation Form
Please print this form in your printer and send it by FAX to (702) 384-4851
or Mail it to: The Stained Glass Chapel, 901 E. Ogden , Las Vegas NV 89119
Select Wedding Date below and Fill the Requested Information
MonthDayYearWedding Time
Marriage Renewal of Vows
Which Package?

Limousine 

How Many Guests?

 

Live Music

Method of Payment:

 Check Card

Bride's & Groom's Names

  If Paying by Card, Please
Include Billing Address

First Name

Credit Card Information

Last Name

Bank Name

Name on a Card:

Card Number:

Expiration Date:
 First Name
 Last Name
Street Address
City
State
Zip Code
Country
FAX

Amount of Deposit:

E-mail

Billing Address
First Name

Last Name

Address

City

State

Zip

Country

Phone

Please Make Check Payable to:
The Stained Glass Chapel
901 E. Ogden,
Las Vegas NV 89101

I am Including:

Deposit for the Wedding

For Fast Processing, Fax Your Check To us
with this Wedding Reservation Form

  Minister fees not Included - Reservation fee not refundable

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