Name *

First Name

Last Name

Wedding Anniversary (Including Year) *

MM

DD

YYYY

Marriage Statements *

Please select all statements below that are true for your marriage history that will help us match you with a mentee couple.

We married late in life (35 years or older)

We married young (under 20 years of age)

This is a second marriage

We have a large family (4 or more children)

We have a special-needs child

We have experienced the loss of a child

We have experienced infertility

We have dealt with the challenge of long work hours

We both work outside the home

We have learned how to stay connected despite a demanding travel schedule

We have experience with difficult in-laws

We are especially practiced at conflict resolution

We have had to learn healthy ways to communicate

We have navigated through an employment crisis

We have pulled through a serious illness

We have experienced unfaithfulness and forgiveness

We’ve gone through a financial crisis together

We have learned the benefit of having a financial budget

We have experienced recovery from an addiction

We have learned the importance of keeping our sex life happy

We especially enjoy doing challenging adventures together

We have found ways to enjoy the same types of activities together

One of us has found healing from a difficult family of origin issue

We have come from a different faith background

We were raised with different cultural backgrounds

Are any of the Red Flag Statements below true for you? If so, this may not be the best time for you to invest in the lives of others. All marriages go through hurdles from time to time. We would encourage you to first, address the issue in your own marriage; and then use your story to mentor others. (1 Corinthians 1:4) *

You are currently battling any kind of addiction (gambling, pornography, drugs, alcohol, etc.)

You have uncontrollable emotional outbursts that you have not yet managed.

You have recently suffered a significant setback (financial, emotional, etc.).

Your marriage is not stable or is fraught with frequent conflict.

You have suffered serious emotional wounds from some kind of abuse in your life and you are still trying to find healing.

You are struggling with significant financial debt.

One of you is far more motivated to become a marriage mentor than the other.

You do not have a sense of meaning and purpose in your life.

You are pessimistic about marriage in general.

You avoid personal responsibility for problems in your life.

You are not content and at peace with your life and your marriage.

You are not living your life by submitting to Biblical principles.

You are primarily motivated to be marriage mentors to help your own marriage.

You have been told by others that you may not be in a good place to be marriage mentors right now.

There are no red flag issues currently occurring inside our marriage