Marriage Kiosk

Applicant 1 - First Name	Applicant 1 - Middle Name

Applicant 1 - Last Name	Applicant 1 - Suffix

Applicant 1 - Last Name at Birth

Applicant 1 - Race	Applicant 1 - SSN

Applicant 1 - Street Address	Applicant 1 - City

Applicant 1 - Residence - State	Applicant 1 - Zip Code

Applicant 1 - County	Applicant 1 - Phone Number

Applicant 1 - Date of Birth	Applicant 1 - State or Country of Birth

Applicant 1 - Have you been previously married?	Applicant 1 - Number of Previous Marriages

Applicant 1 - Last Marriage Ended Date	Applicant 1 - Marriage Ended

Applicant 2 - First Name	Applicant 2 - Middle Name

Applicant 2 - Last Name	Applicant 2 - Suffix Name

Applicant 2 - Last Name at Birth

Applicant 2 - Race	Applicant 2 - SSN

Applicant 2 - Street Address	Applicant 2 - City

Applicant 2 - State	Applicant 2 - Zip

Applicant 2 - County	Applicant 2 - Phone

Applicant 2 - Date of Birth	Applicant 2 - State or Country of Birth

Applicant 2 - Previously married?	Applicant 2 - Number of previous marriages

Applicant 2 - Last Marriage Ended Date	Applicant 2 - Marriage Ended