Welcome

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How Can We Help You Today?* This field is required.Let us know what service you are looking for.
Premarital Counseling
Marriage Mentoring & Strengthening
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Today's Date* This field is required.
Date
Month
Day
Year
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What is your name?* This field is required.
First Name
Last Name
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What is your age?* This field is required.
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What is your home address?* This field is required.
Street Address
Street Address Line 2
City
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Postal / Zip Code
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What is your home phone number?* This field is required.
Please enter a valid phone number.
7
What is your work phone number?
Please enter a valid phone number.
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What is your email address?* This field is required.
example@example.com
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What is your ethnic origin?
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What is your highest level of education?* This field is required.
Middle School
Grade School
Middle School
GED or High School Equivalent
Some College
Associates Degree
Bachelors Degree
Masters Degree
Doctorate
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Are you a Member or Regular Attender at GT Church?* This field is required.
YESNO
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How long have you attended?* This field is required.
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How long have you been a Member or Regular Attender at GT Church?* This field is required.
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Are you attending another church?* This field is required.
YESNO
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What Church are you attending?* This field is required.
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Why do you want to be mentored or counseled?* This field is required.Explain briefly why you have chosen to be a part of the Marriage Matters program.
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How long have you known each other?* This field is required.
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How long have you been dating?* This field is required.
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How long have you been officially been engaged?* This field is required.
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What is your tentative wedding date?* This field is required.
Date
Month
Day
Year
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Where will the wedding be?* This field is required.
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What is your occupation?* This field is required.
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What are your hobbies?* This field is required.Separate with comma.
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What are your pet peeves?* This field is required.Separate with comma.
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What are your strengths?* This field is required.Separate with comma.
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What are your weaknesses?* This field is required.Separate with comma.
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Which answer best describes you?* This field is required.Please select the answer that fits best.
Seeker/not yet a Christ follower
New Christian
Committed Christian
Agnostic
I'm not sure what I believe
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How long have you been married to your current spouse?* This field is required.
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Have you been previously married?* This field is required.
YESNO
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How many times have you been married?* This field is required.
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How long were you married?* This field is required.
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When was the divorce final?* This field is required.
Date
Month
Day
Year
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What was the reason for the divorce?* This field is required.Please keep the answer concise.
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Did you try to reconcile the marriage?* This field is required.
YESNO
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Who filed for the divorce?* This field is required.
Myself
My Spouse
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Was your spouse unfaithful?* This field is required.Did they commit adultery?
YESNO
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Were you unfaithful?* This field is required.Did you commit adultery?
YESNO
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Were you a Christian at the time?* This field is required.
YESNO
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Was your spouse a Christian at the time?* This field is required.
YESNO
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Do you have children?* This field is required.
YESNO
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What is the name of Child Number One?* This field is required.
First Name
Last Name
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What is the age of Child One?* This field is required.
Age in year
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Child one is the child of:* This field is required.
Both Parents
Wife Only
Husband Only
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Do you have any other children?* This field is required.
YESNO
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What is the name of Child Two?* This field is required.
First Name
Last Name
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What is the age of Child Two?* This field is required.
Age in year
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Child Two is the child of:* This field is required.
Both Parents
Wife Only
Husband Only
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Do you have any other children?* This field is required.
YESNO
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What is the name of Child Three?* This field is required.
First Name
Last Name
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What is the age of Child Three?* This field is required.
Age in year
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Child Three is the child of:* This field is required.
Both Parents
Wife Only
Husband Only
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Do you have any other children?* This field is required.
YESNO
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What is the name of Child Four?* This field is required.
First Name
Last Name
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What is the age of Child Four?* This field is required.
Age in year
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Child Four is the child of:* This field is required.
Both Parents
Wife Only
Husband Only
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Do you have any other children?* This field is required.
YESNO
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What is the name of Child Five?* This field is required.
First Name
Last Name
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What is the age of Child Five?* This field is required.
Age in year
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Child Five is the child of:* This field is required.
Both Parents
Wife Only
Husband Only
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Do you have any other children?* This field is required.
YESNO
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I, First Name * Last Name * , understand that the Mentor Couple we meet with are not professional counselors, but rather marriage mentors who agree to help us strengthen our marriage. I understand that we are responsible for the success of our own marriage and do not hold our Mentor Couple or GT Church responsible for the state of our marriage throughout the mentoring sessions or any time thereafter. I understand that the Mentor Couple can discount the Mentoring at any time and that the fee paid for mentoring is nonrefundable.
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