Mentoring Registration

Mentoring Registration

Please use this form to sign up for our Couple-to-Couple Mentoring Program
Name

First NameLast Name
Email
example@example.com
Phone number
Format: (000) 000-0000.
Partner's Name

First NameLast Name
Partner's Email
example@example.com
Partner's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship Status
Wedding Date

MonthDayYear
If you are engaged and know your date, please enter it. If you are dating, please skip.
Do you live together?
Do you have children? (Do either of you have any children? Please list the ages of any children, and whether from previous or current relationship. --If no children put N/A)
Are you in a blended/step-family?
Areas of Focus (What are the aspects of your relationship that you think need the most work? Are there any special circumstances? This information helps us connect you with the couple best suited to your needs.)
Faith Based or Non Faith Based Curriculum? (We offer both a faith based and non-faith curriculum. The workbooks are identical except that the faith based version uses bible quotes. Which would you prefer?)
Meeting Times (Between all of our mentors, we are available to meet during the day, the evenings, or on weekends. If you have a specific time you need to meet, please let us know.)
How did you hear about us?

Other
Comments (If you have any thing else you would like to tell us please do so here. )
Consent (By submitting this form you acknowledge that you and your partner want to move forward with the mentoring program, and you and your partner agree to let Great Marriages share this information with one of our trained Mentor Couples.)

The price for mentoring is a one time fee of $75.

Mentoring Registration ($75/couple)

$75.00 Quantity

Enter coupon

Total

Once you submit this form, we will register you for the Prepare / Enrich assessment. You will receive an email directly from Prepare/Enrich containing the login code to take the online assessment (check your junk or spam if you don’t see it!)

If you do not see the email within 2 business days, please reach out to programs@great-marriages.org.

Payment Methods

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Mentoring Registration

The price for mentoring is a one time fee of $75.*

Payment Methods

The price for mentoring is a one time fee of $75.