Marriage Mentee Application - Wellspring Community Church

Household members

Spouse's information

Address

Do you have children?

Which of the following is the reason for seeking a marriage mentor couple? *

We desire to match you with a mentor couple with whom you have some similarities. *

Please check all of the following that apply.

We married later in life (35 years or older)

We married young (under 25 years of age)

This is a second marriage

We have a large family

We have a blended family

We have a special needs child

We have adopted children

We have experienced the loss of a child

We have experienced infertility

We now have an empty nest

We are dealing with the challenge of long work hours

We both work outside the home

We have a demanding travel schedule

We have difficult in-laws

We want to learn how to have healthy conflict resolution

We want to learn healthy ways to communicate

We are looking for ways to navigate through unemployment

We are dealing with a serious illness

We have experienced unfaithfulness

We are experiencing a financial crisis

We want to prevent any addiction

We want to improve our sex life

We want to do challenging adventures together

We want to pursue and enjoy the same types of activities together

We have a difficult family of origin issue

We have different faith backgrounds

Other

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

Please feel free to write any additional comments that would help us match you with a mentor couple.

Phone number *

Please Provide YOUR phone number.

Spouses Name *

Phone number *

Please Provide YOUR SPOUSES phone number.