Mentor Application Form

His

First Name

Last Name

Phone

Email Address

Street Address

City

Postcode

Hers

First Name

Last Name

Phone

Email Address

Street Address

City

Postcode

Wedding anniversary

Children? (If yes, please provide gender/age)

Please provide child gender/age

Gender *

Age *

Do you believe in Jesus Christ as your Lord and Saviour?

Husband

Wife

In which one of these categories are you most interested in being Marriage Mentors? Please indicate with a tick.Preparing Marriages - Building solid foundations for engaged and newlywed couplesMaximising Marriages - Deepening and enriching stable marriagesRestoring Marriages - Encouraging couples in distress

Will you have the time to meet with a mentee couple a minimum of once a month for 4-6 months? (Please review your upcoming commitments)

4 month commitment? (Y/N)

Starting Month (say “open” if you are flexible)

Other schedule considerations/concerns

If you have experienced an impactful crisis that you are comfortable sharing, please describe the issue and how you dealt with it:

Are any of the Red Flag statements below true for you? If so, this may not be the best time for you to invest in the lives of others. All marriages go through hurdles from time to time. We would encourage you to first, address the issue in your own marriage; and then use your story to mentor others. (1 Corinthians 1:4)

a) You are currently battling any kind of addiction (gambling, pornography, drugs, alcohol, etc.)
b) You have uncontrollable emotional outbursts that you have not yet managed.
c) You have recently suffered a significant setback (financial, emotional, etc.).
d) Your marriage is not stable or is fraught with frequent conflict.
e) You have suffered serious emotional wounds from some kind of abuse in your life and you are still trying
to find healing.
f) You are struggling with significant financial debt.
g) One of you is far more motivated to become a marriage mentor than the other.
h) You do not have a sense of meaning and purpose in your life.
i) You are pessimistic about marriage in general.
j) You avoid personal responsibility for problems in your life.
k) You are not content and at peace with your life and your marriage.
l) You are not living your life by submitting to Biblical principles.
m) You are primarily motivated to be marriage mentors to help your own marriage.
n) You have been told by others that you may not be in a good place to be marriage mentors right now.

According to the Red Flag Statements above, we are in a good place to be effective Marriage Mentors.

Please feel free to write any additional comments here:

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JH Marriage Mentoring - Mentor Application Form