Fellowship Bible Church - Care - Family Ministry

Apply to become a Marriage Mentor This form is to be completed by each person in a couple.
*Name ?
Address
City State Zip #
*Phone ?! Cell !
Email !
*Wedding anniversary ?!
Children? Yes No If yes, provide ages and genders
Previously married? Yes No If yes, please explain
How motivated are you to become a marriage mentor? [very little 1 - 10 very much] 1 2 3 4 5 6 7 8 9 10
Why do you want to be a marriage mentor? -
Under which of these categories are you most interested in being a marriage mentor? [very little 1 - 7 very much] Preparing for Marriage 1 2 3 4 5 6 7 Maximizing Marriages 1 2 3 4 5 6 7 Repairing Marriages 1 2 3 4 5 6 7
What concerns or fears do you have about becoming a marriage mentor? -
Are you willing to participate in a bit of training to become a marriage mentor? Yes No
How would you rate your marriage? [not happy 1 - 10 very happy] 1 2 3 4 5 6 7 8 9 10
What will help you be a particularly good marriage mentor (note any skills, education, life experience, challenges you've overcome, etc.)? -
Please describe the most outstanding crisis you have experienced as a couple and how you dealt with it. -
How would you rate your individual spiritual life (i.e., your relationship with God)? [nonexistent 1 - 10 strong] 1 2 3 4 5 6 7 8 9 10
Please provide your Christian testimony -
If you are not selected to be a marriage mentor at this time, are you willing to be considered again later? Yes No