Marriage Mentor Application Form

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This form captures helpful background information for the Marriage Mentoring Program as well as the matching process with mentorees. Please fill this form out.

Please write both of your first and last names. *

What is his email address? *

What is her email address? *

What is your wedding anniversary (including year?) *

If you have children, please provide their gender/ages.

Do you believe in Jesus Christ as your Lord and Savior? *

Yes (Him)

No (Him)

Yes (Her)

No (Her)

Required

In which of these categories are you most interested in being Marriage Mentors? *

Preparing Marriages: Building solid foundations for engaged and newlywed couples

Maximizing Marriages: Deepening and enriching stable marriages

Repairing Marriages: Encouraging couples in distress

Required

Will you have time to meet with a mentee couple a minimum of once a month for 4-6 months? (If yes, please answer the next few related questions.) *

Yes

Can you do at least a 4 month commitment? *

Yes

Starting Month (say open if you are flexible) *

Other schedule considerations/concerns

Please check ALL statements below that are true for your marriage history that will help us match you with a mentoree couple. *

We married late in life (35 years or older)

We married young (under 20 years of age)

This is a second marriage

We have a large family (4 or more children)

We have a special-needs child

We have experienced the loss of a child

We have experienced infertility

We have dealt with the challenge of long work hours

We both work outside the home

We have learned how to stay connected despite a demanding travel schedule

We have experience with difficult in-laws

We are especially practiced at conflict resolution

We have had to learn healthy ways to communicate

We have navigated through an employment crisis

We have pulled through a serious illness

We have experienced unfaithfulness and forgiveness

We've gone through a financial crisis together

We have learned the benefit of having a financial budget

We have experienced recovery from an addiction

We have learned the importance of keeping our sex life happpy

We especially enjoy doing challenging adventures together

We have found ways to enjoy the same types of activities together

One of us has found healing from a difficult family of origin issue

We have come from a different faith background

We were raised with different cultural backgrounds

Other (if you choose this option, please explain at the end in the comments

Required

If you have experienced an impactful crisis that you are comfortable sharing, please describe the issue and how you dealt with it.

Are any of the Red Flag Statements below true for you? If so, this may not be the best time for you to invest in the lives of others. All marriages go through hurdles from time to time. We would encourage you to first, address the issue in your own marriage; and then use your story to mentor others. (1 Corinthians 1:4) Read through the statements, but you don't have to check the boxes, just reflect on them.

You are currently battling any kind of addiction (gambling, pornography, drugs, alcohol, etc.)

You have uncontrollable emotional outbursts that you have not yet managed

You have recently suffered a significant setback (financial, emotional, etc.)

Your marriage is not stable or is fraught with frequent conflict

You have suffered serious emotional wounds from some kind of abuse in your lfe and you are still trying to find healing

You are struggling with significant financial debt

One of you is far more motivated to become a marriage mentor than the other

You do not have a sense of meaning and purpose in your life

You are pessimistic about marriage in general

You avoid personal responsibility for problems in your life

You are not content and at peace with your life and your marriage

You are not living your life by submitting to Biblical principles

You are primarily motivated to be marriage mentors to help your own marriage

You have been told by others that you may not be in a good place to be marriage mentors right now

According to the Red Flag Statements above, we are in a good place to be effective Marriage Mentors. *

Yes (Him)

No (Him)

Yes (Her)

No (Her)

Please feel free to write any additional comments here:

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