Black B1 Business Card

Thank you for your interest in the Agape Child & Family Services "Becoming ONE" Relationship Skills Education Program.
Please select the Relationship Skills Education Program you would like to participate in.

SEE BELOW:
Click Here to sign up for the MARRIAGE session:

Marriage Enrichment Registration
Click Here to sign up for the SINGLES/INDIVIDUALS session:

Unmarried Individuals Registration
Click Here to sign up for the FATHERHOOD session:

Fatherhood Registration
Haga clic aquí para inscribirse en la sesión a la que desea asistir:

Conferencia de Matrimonio 27 y 28 de Junio 2025

Matrimonio
Husband's Birth Date*

MonthDayYear
Wife's Name*

First NameMiddle NameLast Name
Wife's Birth Date*

MonthDayYear
Wedding Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Wife's E-mail*
example@example.com
Wife's Phone Number*
Referring Organization*
Are You a Pastor, Minister, Chaplain, or Serve in Ministry at a Church or Faith Based Organization?*
If Yes, Please Specify Your Role*
Which series of programming do you prefer to attend?*

Weekly 1.5hr2 Day Conference2 Full Days Saturday (Back to Back)2 Full Days Saturday (Bi-Weekly)Zoom only (evening Sessions)
Husband's T-shirt Size
Wife's T-shirt Size
I understand that meals are provided, however, the venue cannot accommodate individual dietary requirements.*

Yes, I understand
Couple's Favorite Love Song and Artist *
By checking each box below, I AGREE to COMPLETE all the surveys to enroll in the Becoming One Program PRIOR TO THE START OF WORKSHOP. (You and your spouse will receive three $25 gift cards for COMPLETING the surveys and completion of the program.)*
Please Share Any Additional Information Needed
Please Note: PHOTOGRAPHS AND VIDEOS ARE TAKEN AT ALL OUR EVENTS.
Should be Empty:

Please select the Relationship Skills Education Program you would like to participate in.

Please Note: PHOTOGRAPHS AND VIDEOS ARE TAKEN AT ALL OUR EVENTS.