Pre-Marital Counseling Form • Word of Life International Church

This questionnaire should be filled out completely and turned in to the church office. After being reviewed, an appointment will be made to meet with a pastor, at this time we will determine whether or not to begin the pre-marriage counseling.

NOTE: We reserve the right to discontinue the counseling and planning process at any time, at our discretion.

*Both you and your fiancé can complete a questionnaire separately or together, but both must be present for the actual Pre-Marital counseling with the pastor.*

General Information

Have you set a date for your wedding yet? *

Yes

If yes, when?

Personal Information

First Name *

Last Name *

Age *

Address *

Mobile Number *

Email Address *

Fiance` Name *

Age *

Marital Status

Have you been married before? *

Yes

If yes, how many times?

If yes, for how long?

Are you...

Divorced

Widowed

Seperated

Is your divorce final?

Yes

If not, why & when will it be?

Do you have children from a previous marriage?

Yes

If yes, how many?

If yes, what are their ages?

If you are divorced, what is your custody arrangement?

If divorced, why was your previous marriage terminated?

Engagement Period

How long have you know each other? *

How long have you been together? *

How long have you been officially engaged? *

(We require that you have been dating seriously for at least eight months before we will begin counseling)

What brought you together? *

Religious Background

Are you a born again Christian? *

Yes

I don't know

Briefly describe what it means to be Born Again.

Do you regularly attend a church? *

Yes

If yes, which one?

For how long and how often?

Pre-Marital Questionnaire

Please answer the following questions as completely yet as briefly as possible. Remember that our goal is to help you prepare for marriage. Please be honest with your responses. Don’t simply write the answers you think we expect.

What is your definition of "Love"? *

How do you know you love your fiance`? *

How have you prepared for marriage?

Have you read Christian books? *

Yes

If so, please list them.

Have you attended any marriage classes? *

Yes

If so, please describe them.

Have your parents ever been divorced or re-married? *

Yes

If yes, why?

What do you expect to receive from marriage that you cannot have while you are single? *

Give some reasons why you want to marry your finace`. *

List any concerns about marrying your finace`. *

What do you see as YOUR role in the marriage? *

What do you see as your FIANCE`s role in the marriage? *

With so many marriages failing today, what guarantee will you have that your marriage will remain successful? *

How do other members of your family feel about your fiance? *

How do you feel you are accepted by your fiance's family? *

How will you handle conflict or disagreements *

Do you plan on having children? If so, how many? *

Who will discipline your children and how? *

Who will handle your finances? If there are differences, how will you handle them? *

Thoughts and plans for emergency funds? (if appliance repair or emergencies arise) *

Creating a special time for dating. What plan do you have? *

What plans do you have to keep your marriage fresh and alive? *

Sports, TV, shopping and other boundaries and limitations you can be agreed on? *

Priorities on purchasing items other than using credit cards? *

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Please Note:

Performance of marriage ceremonies is an accommodation to the body, NOT an obligation. It is understood that entering into pre-marital counseling is NOT an agreement of approval to be married by this pastor or anyone else at this church. We do not claim to be “Professional” Counselors. Our counsel is based solely on God’s Word. Be sure you thoroughly understand our position, before signing below.

I acknowledge that I have read and understand the above, and that all of the information filled in is true and correct to the best of my knowledge.

Signature of future husband *

Date *

Signature of future wife *

Date *