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LIFELINE CHURCH PREMARITAL SURVEY
GENERAL INSTRUCTIONS

1. This survey is to be completed by you in its entirety without any discussion of your responses with your fiancé.

2. Please do not select a wedding date until after you have completed the Married Life Class. If you have already selected your wedding date, the date is not secure with Lifeline Church until we have checked the dates with the church calendar and the clergy schedule. Please be advised that all premarital counseling will be assigned to a LC Clergy member based on need and availability. All non LC Partners requesting counseling will be assessed a fee of $75.00 per hour.

3. After Married Life Class is complete the next step would be to make sure you get a wedding packet from the church main office.

4. If you should have any questions regarding the survey, please call the LC Members Care Office at 708 477-6686.

5. All information will be kept confidential.

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PRE-MARITAL SPIRITUAL GUIDANCE SURVEY
GENERAL INFORMATION
Today's Date
MM
/
DD
/
YYYY
Your Name
Your answer
Address
Your answer
Home Telephone
Your answer
Work Telephone
Your answer
Your Age
Your answer
Fiancé/Spouse Name
Your answer
Are you now engaged?
Pre-Marital Sex ?
Are you currently living together?
Length of Association:
Your answer
Previous Marriage(s)?
If yes, how long?
Your answer
Choose One:
Marriage ended because of (please check all that apply):
Required
Children?
If yes, how many?
Your answer
Choose One
Child(ren) from previous marriage(s)?
Children born out of wedlock?
Are you currently working a job receiving income?
Monthly income?
Your answer
Name of Employer
Your answer
Do you have any debt?
Do you have any savings accounts?
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