The work of DignityUSA on April 19, 2015 could have been sponsored by you. Click here for more information.

Registration of Holy Union For the DignityUSA National Registry

 Please Print

First Person

Second Person

Full Name:









State & Zip:






If the last names will change after the Holy Union, please indicate the new names here:




Date of Holy Union:






DignityUSA Guidelines

*The Chapter President/Representative must verify the following*

  1. Both members of the couple shall be at least the legal age of consent for marriage in the state in which the ceremony is to be performed.
  2. Neither member may be bound by a prior marriage or unresolved commitment.
  3. At least one member of the couple must be an active member of a Dignity Chapter.
  4. The couple must inform the chapter leadership of their intention and work with the individuals designated by the chapter for preparation for their Holy Union.
  5. The couple must have completed the program of preparation adopted by the local chapter for Holy Unions.

Chapter President/Representative:



Please print & mail this form to:

DignityUSA, PO Box 376, Medford, MA 02155
or FAX to: 781.397.0584