Marriage Intensive Coaching Application
We are delighted that you are considering marriage coaching with us. In order to be considered, both spouses need to fill out this form and submit it separately.
This form shows your interest in working with us in a one month intensive program to work on setting goals for one specific issue in your marriage.
After receiving your responses, we will review your answers to help us determine if we are a good fit for coaching. If we accept your application, we will contact you to set up a discovery call.
Email address *
Last Name *
Your answer
Husband First Name *
Your answer
Wife First Name *
Your answer
I am the... *
When is your anniversary? *
MM
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DD
/
YYYY
Address *
Your answer
City, State, Zip *
Your answer
What is the main problem that led you to try marriage coaching? *
Your answer
How long have you been married? *
Your answer
How long did you date before you were married? *
Your answer
On a scale of 1-10, describe your level of commitment to your relationship. *
On a scale of 1-10, describe how much you love your partner. *
List three things you admire about your spouse. *
Your answer
List three things about living with your spouse that are difficult. *
Your answer
In what area of your marriage would you like to see the greatest change? *
Your answer
What do you hope to get out of marriage coaching? *
Your answer
Do you have a coupon code? Put it here! *
Your answer
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