Marriage Mentoring Application – Bride/Wife

    Mentor Request Form: Bride/Wife

    What is your affiliation with Valley Life Church?

    I am not a regular attenderI am a regular attenderI am a member

    If you do not attend Valley Life Church, do you have another church home?

    How would you describe the current state of your marriage?

    For Pre-Marital Only

    More About You

    Occupation

    Hobbies

    Pet Peeves

    Strengths

    Weaknesses

    Check the answer below that best describes you
    Seeker/not yet a Christ followerNew ChristianCommitted ChristianDo not believe in JesusI am not sure what I believe

    Marital Status

    Parent: BothWife onlyHusband only

    Test:oneTWOTHREE
    SMMEDLG

    Children

    YesNo
    yesnomaybe

    Parent: BothWife onlyHusband only

    Test:oneTWOTHREE
    SMMEDLG

    Children

    Mentee Agreement

    I understand that the Mentor Couple we meet with are not professional counselors, but rather marriage mentors who agree to help us strengthen our marriage. I understand that we are responsible for the success of our own marriage and
    do not hold our Mentor Couple or Dare to be Different responsible for the state of our marriage throughout the mentoring sessions or any time thereafter. I understand that the Mentor Couple can discontinue the mentoring at any time and that the fee paid for mentoring is nonrefundable.
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