Episcopal Diocese of Central Pennsylvania Request to Officiate at a Wedding by clergy not canonically resident in the Diocese of Central Pennsylvania Clergy who are not canonically resident in the Episcopal Diocese of Central Pennsylvania must request permission from the Bishop of Central Pennsylvania to officiate in the diocese at a wedding. The following information must be provided prior to obtaining the Bishop’s permission to officiate at a wedding within the Diocese of Central Pennsylvania.	To:	The Rt. Rev. Audrey C. Scanlan, Bishop of the Diocese of Central Pennsylvania

Information about Priest

Name:	Click or tap here to enter text.	Canonical Residence: Click or tap here to enter text.

Address: Click or tap here to enter text.

Phone: Click or tap here to enter text.	Email: Click or tap here to enter text.

Information about the Ceremony	Date of Ceremony: Click or tap to enter a date.

Will the ceremony take place at an Episcopal Parish in the Diocese of Central Pennsylvania? ☐ Yes ☐ No

If yes, Parish Name and address: Click or tap here to enter text.

If not at a Diocese of Central Pennsylvania parish, name of location: Click or tap here to enter text.

Where will this marriage be recorded? Click or tap here to enter text.

I ask your consent to celebrate and bless the marriage of

Information about Applicant 1

First Name: Click or tap here to enter text.	Last Name: Click or tap here to enter text.

Has the applicant been baptized? ☐ Yes ☐ No If Episcopalian, applicant’s parish: Click or tap here to enter text.

Has the applicant been married previously? ☐ Yes (if yes, number of times) Click or tap here to enter text. ☐ No

Information about Applicant 2

First Name: Click or tap here to enter text.	Last Name: Click or tap here to enter text.

Has the applicant been baptized? ☐ Yes ☐ No If Episcopalian, applicant’s parish: Click or tap here to enter text.

Has the applicant been married previously? ☐ Yes (if yes, number of times) Click or tap here to enter text. ☐ No

Have you received permission from your bishop for this re-marriage to take place? ☐ Yes ☐ No

Information about the Couple

Have they signed the Episcopal “Declaration of Intention”? (Canon I.18.3.e-g) ☐ Yes ☐ No

Describe the pre-marital counseling for this couple: Click or tap here to enter text.

Permission Granted:

Priest’s Signature	Bishop’s Signature

Date of Consent:

Please return completed form to:

The Right Rev. Audrey C. Scanlan via email to the bishop’s executive assistant at nfree@diocesecpa.org