PREPARE/ENRICH
Cou
ple Registration Form
[FrontPage Save Results Component]
Partner 1
First Name
Last Name
Age
Street Address
City
State
Zip
Home Phone
Cell Phone
Email Address
What is your religion or denomination?
Partner 2
First Name
Last Name
Age
Street Address
City
State
Zip
Home Phone
Cell Phone
Email Address
What is your religion or denomination?
Marital Status (Check which one applies) Married
Engaged
Dating
Dating which one applies: We live together
We live separately
One or both of us have children from a previous relationship
There is no cost to submit this form, there is a $29.99 fee for taking the Prepare/Enrich assessment on line.
Please print the form and give it to a mentor or send it to
Enrich@sbcglobal.net
