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FOCCUS Online Registration Form

 

We treat your personal information as confidential, and will release it only as might be necessary to serve you, and only to duly recognized representatives of the Diocese of St. Augustine, St. Vincent's Medical Center, or the priest(s) and parish(es) you designate below. 

Click here for more information on our Privacy Policy.
 

Bride's Information


First Name
Middle Initial
Last Name
E-Mail Address*
 

* FOCCUS can only be taken online with a valid User ID and Password that will be assigned to you and sent via e-mail.  Please be sure to enter a valid e-mail address.

Groom's Information

First Name
Middle Initial
Last Name
E-Mail Address*
 

* FOCCUS can only be taken online with a valid User ID and Password that will be assigned to you and sent via e-mail.  Please be sure to enter a valid e-mail address.

Wedding Information

Wedding Date
Priest Assisting
Church
Address
City, State, Zip

General Information

Select a Payment Method:

VISA   MasterCard   Check    Other

If paying by credit card, please complete requested information on the next page.

Comments:



User ID and Password will be assigned and provided via e-mail ONLY when payment has been received in full.  Checks should be made out to Diocesan Center for Family Life.

Any questions, please contact (904) 308-7474



    

"So they are no longer two but
one flesh.
Therefore, what God has joined together, no
human being must separate."

Matthew 19:6

  
 2577 Park Street    
   Jacksonville, FL 32204    
   Phone (904) 308-7474    
Copyright © 2007 Diocesan Center for Family Life                                                                                             Fax (904) 308-4087    

                                            Diocese of St. Augustine St. Vincent's Medical Center