Marriage Mentoring Request Form
This information will help us get a better grasp of how to help come alongside you. Please write only what you feel comfortable sharing.
* Required
Husband's First Name
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Your answer
Husband's Last Name
*
Your answer
Wife's First Name
*
Your answer
Wife's Last Name
*
Your answer
Husband's Email
*
Your answer
Wife's Email
*
Your answer
Husband's Phone
*
Your answer
Wife's Phone
*
Your answer
Preferred method of contact
*
Email
Phone call
Text message
Husband's Age
*
Your answer
Wife's Age
*
Your answer
How many years have you been married?
*
Your answer
Are you:
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Sojourn East members
Sojourn East attenders
members of another Sojourn church
members of another church
not members of a church
Other:
Are you in a Community Group (CG)?
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Yes
No
If you are in a Community Group, who are your leaders?
Your answer
Any children? Please list names, ages, and gender (if applicable).
*
Your answer
Have either of you been previously married?
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Your answer
Briefly describe why you are seeking marriage mentoring:
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Your answer
In specific terms, what are you hoping that a marriage mentor couple will help you accomplish?
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Your answer
Please list any area of serious conflict that would be important for us to know before assigning you to a mentor couple.
*
Your answer
Have you received counseling/pastoral care as a couple before?
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Yes
No
If there's anything else you think we should know, please write that here:
Your answer
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