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Wedding application

Your name *

Last name

Email address *

Address *

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Birthdate *

Fiancé Information

Fiancé Name *

Fiancé Birthdate *

Fiancé Email *

Fiancé Phone Number *

Relationship information

Are you officially engaged? *

Yes

What is your anticipated wedding date? *

Do you wish to have me perform the pre-marital counseling? *

Yes

Unsure

If not, who will be doing your pre-marital counseling?

Please type n/a if this does not apply

Do you authorize the person(s) involved in this process to speak openly and confidentially with each other about subjects discussed in counseling? *

Yes

How did you meet and how long have you been dating each other? Please briefly state several reasons why you decided that you should get married: *

From Monday – Thursday, what days and times are you typically available for scheduling several sessions of approximately one hour each? *

What do you hope to receive from your pre-marital counseling sessions? *

Have either one of you been married previously? If so briefly identify the reason for termination of prior marriage (i.e. divorced, widowed, etc.). *

Do either of you have any children from a previous marriage or relationship? *

Yes

Please share a bit about your church and / or spiritual background (both partners must respond): *

What effect has Jesus Christ had on your life, and what is your current relationship to Him? (both partners must respond) *

Confidentiality agreement *

If you are applying for the pre-marital counseling process, do you both trust me to keep information confidential and do you agree to be open and honest regarding all issues addressed in the course, including sensitive subjects such as spirituality, financial matters, sexual ethics, and past relationships?

Yes

Applicant understanding and agreement *

We certify that the above information is true and correct, and we understand that all counseling and conferring regarding the prospective marriage will be kept confidential, unless otherwise agreed upon by all parties involved. Furthermore, we understand that this application is not a legally binding contract for officiation of marriage by any pastor and that the counseling and officiation agreement may be terminated at any time by either the pastoral counselor or the counselee(s) at their individual discretion.

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Valley Church
info@valleychurch.com
855-774-7223