Marriage Guidance Request Form
All information submitted will remain confidential.
* First Name
* Last Name
* Spouse's Name
* Address
* Mobile Phone
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* Email
* Church Member Type
Select a member type
Business
Company
Deceased
Legacy Academy
Local Pastor
Men's Retreat Only
Missionary
Out of Town Visitor
Unknown
* How long have you been attending Grace Life?
Select one
I'm a first-time guest at the EAST campus.
I'm a first-time guest at the NORTH campus.
I've attended before but would like more information on GLC EAST.
I've attended before but would like more information on GLC NORTH.
I've attended and connected already
* I serve as a volunteer at Grace Life Church.
Select one
Yes
No
* If yes, please specify in which ministry you serve:
* How many years have you been married?
* Have you been married previously?
Select one
Yes
No
* Do you have any children from a previous marriage or relationship?
Select one
Yes
No
* Do you have any children with your current spouse?
Select one
Yes
No
* Please list ages of children:
* Are you a born-again Christian?
Select one
Yes
No
* Please give a detailed description of why you are seeking guidance:
* How long has this issue existed?
* Have you spoken about this issue with anyone in GLC leadership?
* Are you currently seeing, or have you seen, a counselor about this?
Select one
Yes
No
* If you have seen a counselor, but not for the same reason, then why?
* What results are you expecting from guidance?
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