Strong Men Strong Marriages Application Form
You are already showing that you are a MAN OF ACTION by completing this application. All answers are 100% CONFIDENTIAL and WILL NOT be shared.
Basic Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Where did you hear about Strong Men Strong Marriages?
*
Strong Men Strong Marriages Podcast
YouTube
Facebook/Instagram Ad
Referral from previous client
Other
What is the biggest challenge in your marriage right now?
*
Low Sex/Intimacy ("Roommates")
Infidelity
Separation
Divorce
Other
Where do you want your marriage to be?
*
Increased sex and intimacy
More fun
Modeling the type of marriage I want for my kids
Other
About You
At Strong Men Strong Marriages, we work with high achieving Christian men. We want to make sure you're a fit.
What do you do for work?
*
Business Owner
Professional
Executive
Investor
Other
Do you aspire to live Christian values (our program has faith as a core principle)?
*
Yes
No
I don't consider myself Christian, but agree with the principles of honesty and integrity
Other
Do you commit to being emotionally and sexually faithful to your wife while we work together?
*
Yes
No
Time And Money
Creating an intimate marriage can absolutely be done. And like anything worthwhile, it requires time and money. Are you ready to invest both?
Are you ready, willing and able to commit an hour a day for 90 days to create a strong, fun, passionate marriage?
*
Yes
No
Are you ready, willing and able to invest $3,500 to $15K+ to create the type of marriage you want for your kids and future generations? (This can be a business expense if you have a business)
*
Yes
No
Submit My Application
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