PRE-MARITAL COUNSELING APPLICATION

name *

First Name Last Name

address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

cell phone number *

Area Code Phone Number

home phone number

Area Code Phone Number

email *

birth date

Month Day Year

gender *

age *

fiance's name: *

fiance's age: *

Have you been married before? *

How long:

Is the divorce final?

How long:

Why was your previous marriage terminated?

Do you have children?

If yes, give names & ages:

Are you still living at home?

If no, do you live by yourself?

If you have roommates, describe how you get along with them:

Education: last grade completed (prior to college)

Other Education (list type & years)

Referred here by:

What church are you currently attending?

Pastor's name:

May we contact your pastor for information & help?

Do you want a Calvary SLO Pastor to officiate your wedding? *

Why do you want a Calvary SLO pastor to officiate your wedding?

Explain your involvement in church.

What is your religious background?

Have you been baptized?

Does your fiance attend church?

Which church?

What is their involvement like?

Do you believe in God?

Do you pray to God?

Do you read the Bible?

How often do you read your Bible & pray with your fiance?

Explain how you share your spiritual life with your fiance:

If you died tonight, do you believe you will be with God? *

What is the basis for answering the last question as you did? *

If you have received Christ as Savior, what changes took place in your life?

Check any of the following words that you believe best describe you:

How long have you known each other?

How long have you seriously dated?

Have you ever broken off your relationship? *

Why? *

Are you officially engaged?

Do your parents approve?

If they do not approve, please explain:

Are you currently living with the person you are going to marry? *

Do you feel that it is improper to engage in sex before marriage? *

What is the date & location of your wedding?

What pastor will be performing the wedding ceremony?

Are your parents still married? *

If no, how long have they been divorced?

Our Goal – Our goal in providing training is to help you meet the challenges of life in a way that will please and honor the Lord Jesus Christ and allow you to fully enjoy His love and plans for your life.

Biblical Basis – We believe that the Bible provides thorough guidance and instruction for faith and life. Therefore, our training is based on scriptural principles. Neither the pastoral nor the lay counselors of this church are trained or licensed as psychotherapists or mental health professionals. We seek to ‘make disciples’ as Jesus commanded, and thus seek to help you in developing your relationship with Him.

Confidentiality – Confidentiality is an important aspect of the counseling process, and we will carefully guard the information you entrust to us. This completed form and any pertinent information will be filed with Calvary SLO for documentation and reference purposes. There are five situations when it may necessitate sharing certain information with others: when a coach/trainer is uncertain of how to address a particular problem and needs to seek advice from another pastor or elder; when a counselee attends another church and it is necessary to talk with his/her pastor/leaders; when there is a clear indication that someone may be harmed unless others intervene; when a person persistently refuses to renounce a particular sin and it becomes necessary to seek the assistance of others in the church to encourage repentance and reconciliation; or when a crime has been committed (see Proverbs 15:22; Proverbs 24:11; Matthew 18:15-20; Deut. 13:6-8). Please be assured that our trainers/coaches strongly prefer not to disclose personal information to others, and they will make every effort to help you find ways to resolve a problem as privately as possible.

Resolution of Conflicts – On rare occasions a conflict may develop between a trainer/coach and those being trained/coached. In order to make sure that any such conflicts will be resolved in a biblical and faithful manner, we require all those being trained/coached agree that any dispute that arises with a trainer/coach or with this church as a result of counseling will be settled by mediation and, if necessary, legally binding arbitration.

Having clarified the principles and policies of our training ministry, we welcome the opportunity to minister to you and to be used by Him as He helps you to grow in spiritual maturity and prepares you for usefulness in His body. If you have any questions about these guidelines, please talk with a pastor or elder before your training. If these guidelines are acceptable to you, please sign below.

signed *

counselee

date *

PRE-MARITAL TRAINING APPLICATION

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