We’re thrilled that you’re applying!
We can’t wait to help you build a rock-solid relationship.Applications are reviewed every few days, though processing may take up to a week. You’ll receive an email notifying you of your application status.Applying is free, with no obligation to purchase upon acceptance. If approved, we’ll send you a link to enroll and complete your purchase.Looking forward to getting to know you! Jonny & Pietze
Spouse 1
*
First Name
Last Name
Spouse 1 Age
Spouse 2
*
First Name
Last Name
Spouse 2 Age
Years married
Do you have children? (if so please elaborate with any notable details that impact your marriage, young kids, adult children, children from other relationships, etc.)
Main problems in your relationship.
Main positive aspects of your relationship.
Notable traumas from outside of marriage Spouse 1 (childhood and any other aspects of life etc.)
Notable traumas from outside of marriage Spouse 2 (childhood and any other aspects of life etc.)
Notable mental or physical issues that affect the marriage. (ADHD, depression, chronic illness or pain, autism, borderline personality disorder, bi-polar, etc.)
Previous Counseling/Consulting (check all that apply)
Marriage Counseling
Individual Counseling (Spouse 1)
Individual Counseling (Spouse 2)
Sozo
Pastoral Counseling
Other
Previous Courses/Education (check all that apply)
Pathway to Freedom
Living Fully Alive
LCMC
Jonny and Pietze on "The Connected Life" podcast
Other
Results of Previous Counseling and Education
Describe your faith/spirituality as individuals.
Describe your faith/spirituality as a couple.
If you are not a person of faith, will it be offensive to you to hear references from the Bible and Christianity
Yes
No
Where does your motivation for being married, and staying married come from? (eg. faith, morality, family, society, etc.)
What do you hope to gain from attending Marriage for Humans the Masterclass?
Email Address
*
example@example.com
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