Admissions Questionnaire
Please fill out EVERYTHING the best that you can.
First Name
Your answer
Last Name
Your answer
We would like a chance to get to know you! Please answer the following questions.
What special interests/hobbies do you have?
Your answer
What are some of your favorite foods?
Your answer
What foods do you absolutely dislike?
Your answer
Describe a typical day in your life.
Your answer
Our goal is to give opportunities and tools to young women who want to make positive choices in their lives. Could you share some of the desires and goals that you have and how you feel the Family LIFE Center can assist you in achieving them? (This can involve education, life work, individual or family life, spiritual matters, skills you would like to acquire, etc.)
Your answer
How would you describe your relationship to God? Where would you like to be in your relationship with God?
Your answer
How do you feel about weekly church attendance?
Your answer
Have you reached a decision on whether you will parent or place your child for adoption? If so, how did you reach your decision?
Your answer
Are there any special needs or concerns we should be aware of? (Medical, emotional, etc.)
Your answer
What are some personal qualities you posses that will contribute to maintaining a positive atmosphere in the household?
Your answer
What do you hope to see happen in your stay at the Family LIFE Center?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Family Life Center of West Michigan. Report Abuse - Terms of Service