Marriage Mentoring Request Form

*Each spouse is requested to complete this form separately.*

Thank you for your interest in marriage mentoring. Both spouses filling out this form separately will help us pair you with a mentor that fits you as a couple. Answering these questions openly and honestly will help us point you toward the best support for your marriage. Your answers are confidential and only seen by Pastors and Marriage Ministry Leaders at HopeCity. We are praying for you as you embark on what we pray will be a rewarding and enriching year for your marriage.

Note: Once we receive both forms, we will respond with next steps.

Your name *

Email address *

General Information:

Phone number *

Best way to reach you *

Address *

Birthdate *

Is HopeCity your home church? *

How did you hear about Marriage Mentoring? *

Relationship Information:

Name of Spouse *

(First name, Last name)

Spouse's Birthdate *

How long have you been together? *

How long have you been married? *

Were you previously married? *

Was your spouse previously married? *

Rate your marital relationship satisfaction: *

min: 1 / max: 10

(1 being not good at all, 10 being perfect)

If you have children, what are their names and ages?

Why are you interested in being mentored? *

Briefly describe your relationship: *

What challenges have you faced as a couple? It is important to note areas of past or present struggle such as infidelity, loss of a child, any kind of abuse in your relationship, etc. so that we can provide or recommend the best support for your marriage. *

Some things we should know about you: *

We want to be wise and prayerful in matching Mentor with Mentee couples. To help with that process, what are some things we should know about you (interests, job, hobbies, etc.)?

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