Marriage licenses are issued by appointment only. After you submit this form, call the Circuit Clerk's office at 601-636-3961 to schedule your appointment. Both people must appear together with valid photo ID. Bring any documents the office asks for (such as a divorce decree). Do not send documents through this form.
Fields marked "required" must be filled in.
First name (required)
Middle name
Last name (required)
Suffix
Maiden name (if any)
Street address (required)
City (required)
State (required)
ZIP code (required)
Phone (required)
Email (required)
Sex (required)
Date of birth (required)
Place of birth (required)
Race (required)
Driver's license number and state (required)
Marital status (required)Choose…Never marriedWidowedDivorcedMarried
Number of times married (required)
Date and way the last marriage ended (if any)For example: divorced, March 3, 2019. Bring a certified copy of any divorce decree to your appointment.
Highest grade completed (and years of college, if any) (required)
Employer (required)
Occupation (required)
Father's full name and address (required)
Mother's full maiden name and address (required)
Submit pre-application
Please do not include Social Security numbers or other sensitive personal information.
