Church Of The Apostles Confidential Application For Marriage (Page 2 of 5) in pdf

TO B E C OMPLETED B Y T HE B RIDE:

Your N ame: _ _____________________________________________________________________________________

FAMILY I NFORMATION

Information a bout c hildren ( if a ppropriate):

N ame

A ge S ex L iving E ducation P arent

Yes N o ( in y ears)

___________________________ _ ____ _ ___ _ __ _ __ _ ___________ _ ______________________________________

If y ou w ere r aised b y a nyone o ther t han y our o wn p arents, p lease e xplain.

____________________________________________________________________________________________________

How m any o lder b rothers _ _______ s isters _ _______ d o y ou h ave?

How m any y ounger b rothers _ _______ s isters _ _______ d o y ou h ave?

EDUCATION:

(Last y ear c ompleted) H igh S chool _ ____________ C ollege D egree _ ___________

Other t raining ( list t ype a nd y ears) _ ___________________________________________________________

_ ___________________________________________________________________________________________________

Schools a ttended _ _______________________________________________________________________________

HEALTH I NFORMATION:

Rate y our h ealth ( check): V ery G ood _ ___ G ood _ ___ A verage _ ___ D eclining _ ___Other _ ___

List a ll i mportant p resent o r p ast i llnesses, i njuries, o r h andicaps

____________________________________________________________________________________________________

Are y ou p resently t aking m edication? _ ______If s o, w hat? _ ___________________________________

Have y ou u sed d rugs f or o ther t han m edical p urposes? Y es _ ____ N o _ _____

What? _ ___________________________________________________________________________________________

Have y ou e ver h ad a s evere e motional u pset? Y es _ ___ N o _ ___ E xplain____________________

____________________________________________________________________________________________________

Have y ou e ver h ad c ounseling b efore? Y es _ ___ N o____What w as t he o utcome?

____________________________________________________________________________________________________

RELIGIOUS B ACKGROUND:

Member o f C hurch o f t he A postles? _ ______ O ther? _ _____________ H ow l ong? _ _____________

Date b aptized_______________ D ate c onfirmed__________________

Average c hurch a ttendance p er m onth ( circle)

0 1 2 3 4 5 6 7 8 9 1 0+

Church a ttendance p er m onth i n c hildhood? ( circle)

0 1 2 3 4 5 6 7 8 9 1 0+

For t he q uestions b elow, p lease l imit y our a nswer t o t he s pace a llowed.

Church Of The Apostles Confidential Application For Marriage Page 2