First Name *

Middle Name

Last Name *

If you have done a change of name, state original name

Phone

E-Mail *

Date of birth

Fiancé(e)’s information: Name

Fiancé(e)’s Date of birth

Are you a born-again Christian? YesNo

If yes, When?

Where?

Name of your church

Pastor’s name

Pastor’s Tel

Marital status SingleMarriedSeparatedDivorced

Have you had any children before? YesNo

If yes, how many? 123456789101112131415

Name with Age of Children

Your highest educational level High schoolDiplomaBachelor’sMaster’sDoctorateOthers)

Are you employed? YesNo

Father’s First Name

Father’s Last Name

Religion ChristianityIslamOthers

Marital Status SingleMarriedSeparatedDivorced

Relationship MonogamistPolygamist

Mother’s First Name

Mother’s Last Name

Religion ChristianityIslamOthers

Marital status SingleMarriedSeparatedDivorced

When did you meet your partner?

How did you meet your partner?

How did you know he/she is God’s will for you?

Proposed date of marriage ?

Where?

Do you have any behavior, habits, dispositions (e.g., anger, lustfulness, etc.) that you need prayers for? YesNo

If Yes, Explain