Your Name

1. Please identify and describe yourself:

   Age
   Sex	Male Female
   Height
   Weight
   Hair color	Blonde Brown Black Red Gray White
   Eye color	Blue Brown Black Green Gray Violet

Choose the one that best describes you today:  Single Divorced Not in A Relationship Engaged Married Not engaged, but thinking of asking Not Sure if marriage is the right thing at this time

If engaged, how long before the wedding? Or other: Married So Does not Apply In a Relationship That Is In a State of Limbo Divorced & Scared within three months within six months within twelve months undecided on the date

Have you ever been married before?  Never been married Married But.... 1 Previous 2 Previous 3 Previous Marriages More than 3 Does it really matter?

If you are married, how long? Does not apply Less than 3 months Less than 6 months A Year or Less Five Years or Less Seven Years or Less More than 10 Years

Are there children in the marriage or relationship?  No children Children from Previous Marriage 1 Child 2 Children 3 Children More than 3 Children

If you had a previous marriage(s), were you either Divorced or Widowed? Does not apply Divorced Widowed

If Divorced, how long since the Divorce was final?  Does not apply Less than 3 Months Less than 6 Months Less than a year At Least Year and a half

Were you the instigator of the Divorce?  Yes No Does not apply Considering

What were the grounds for the divorce being granted by the court? Do not want to even think on this one! Irreconcilable Differences Adultery Abuse Just Plain tired of being married. Other

Information regarding your Mate:

Has your mate ever been married before? Never been married 1 time before 2 times before 3 times before More than 3 times Do not really care Widowed

Are there any children from this persons previous relationships? Yes No

If Divorced, how long since the Divorce was final?  Does not apply Less than 3 months Less than 6 months Less than a year More Than a Year and Half

Was your mate the instigator of the Divorce?  Yes No

What were the grounds for the divorce being granted by the court? Does not Apply Irreconcilable Differences Adultery Abuse Does not matter

Moving on!

In looking at the relationship or position you are currently involved, would you say that you are Extremely happy Happy Comfortable Could be happier Needing a lot of Work! I Have Some Concerns

What would you say is the one thing that bugs you the most about your mate or your lifestyle? Manners Family (if Married or Considering) Responsiblity Compassion Job Children from Previous Marriage Habits

What is the one thing you admire the most about your life now or mate? Job Beliefs and Values Reliablity Looks

If you could change anything at all about your current relationship, what would it be?

In looking at the lives of your friends who are in relationships or marriages would you want to be more like them or, make your own direction?

In looking at the marriage vows as given by the church, which would you consider the 1st most important? I Do or I Will Honor Cherish Til Death Do You Part In sickness and in health Not really thought about it

Second most important? Honor I Do or I Will Cherish In Sickness and health Til Death Do you part Not really thought about it

Third most important ? Honor Cherish In sickness and health Til Death do you part Not really thought about it I Do or I Will

Of least concern ? honor cherish in sickness and health til death do you part Not really thought about it I Do or I Will

If you could tell your mate or friends anything what would it be?
 

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