Married Couples Mentoring Application

We're so glad you are interested in being matched with a marriage Mentor Couple who will commit to walking alongside you in your marriage. You're making a great decision to get involved in this program.

PLEASE COMPLETE ONE APPLICATION PER PERSON so we can pair you with the mentor couple that will be the best match for you!

Your name *

Email address *

Address *

Phone number *

Birthdate *

Name of Spouse: *

Do you have children? *

Yes

If yes, provide ages and genders:

Previously married? *

Yes

If yes, please explain:

Church affiliation: *

How would you rate your marriage? *

In specific terms, what are you hoping that a Marriage Mentor Couple can do for you? *

Is there an area of your relationship you would specifically like to address with your mentor couple? *

Examples include communication, conflict resolution, trust, role & responsibilities, finances, family dynamics...

Is there an area of your relationship that is particularly difficult to discuss with your spouse? *

Do you have any unusual scheduling issues that may impact when you can meet with your mentors? *

How did you learn about CPC's Marriage Mentoring? *

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