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PRE-MARITAL QUESTIONNAIRE

Fill out the following completely. Please be prepared to discuss your responses during your class sessions.
Name ____________________________________

Age _____________________________________

Address ____________________________________________
State _______

Zip _________________

City _______________________________

Occupation _____________________________________

Phone (h) _____________________(w) _______________________ (c) _____________________________


Do you attend New Life? __________

How Long? ___________________________________________

If not, which church do you attend? _______________________________

How Long? _____________

Are you involved in a Life Group? ________________________________

How Long? _____________

Leaders Name ___________________________________________________________________________


Favorite Hobbies and Sports ________________________________________________________________
Educational Background _______________________________________ (List highest grade, degree, or diploma)
OTHER REFERENCE
Name ___________________________________

Phone ___________________________________

E-Mail Address ________________________________________

Relationship ___________________

MARITAL STATUS
Have you been previously married? ____________

How many times? __________________________

Is the Divorce Final? ________________________

When? __________________________________

Do you have any children?_________

Ages _______________________________________________

Explain custody and visitation arrangements ____________________________________________________


_______________________________________________________________________________________
Why was the marriage terminated? ___________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
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Did you try reconciling? _________________ What was the result? __________________________________
________________________________________________________________________________________
Your Fiancs Name ________________________________________
How long have you known each other? ___________

How long have you steadily dated? ____________

When were you engaged? _____________________

Do you have parents approval? ______________

Where and when will you be married? ___________________________ By whom? _____________________


What city will you live in after you get married? ____________ Will you then live by yourselves? ___________
Your future address and telephone if known: ____________________________________________________
How far have you gone on your wedding plans?

Havent started ___

Started ___

Almost Done ___

Have you made plans for your honeymoon?

Havent started ___

Started ___

Almost Done ___

Do you have any difficulties in planning for your marriage, honeymoon or post-marriage days? ________
If so, please state in which area(s) you have difficulty _______________________________________
________________________________________________________________________________________
Why are you getting married? ________________________________________________________________
________________________________________________________________________________________
SPIRITUALITY & BELIEFS
Are you a Christian? Yes ___ No ___

When _________________________________________

Briefly define your Christian faith: _____________________________________________________________


________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Briefly state your views regarding the authority of the Bible and its place in your life: _____________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
What is your commitment as a couple to reading the Bible and praying together? _______________________
________________________________________________________________________________________
How will you exercise your spirituality as a couple? _______________________________________________
________________________________________________________________________________________
How will you exercise your spirituality as a family? _______________________________________________
________________________________________________________________________________________
BACKGROUND INFO
Are your parents still living? Yes ___ No ___ Only One_______

Where do they live? ____________

Occupation (or former if retired)

Mother: ______________________

Father: __________________

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Are your parents Christians? _________

If so, can you talk about your spiritual life with them? __________

Have your parents ever been separated or divorced? ____________

When was this? ________________

Has either of your parents ever remarried? _______________________ Do you have a step family? ______
If so, please describe your relationship with your step family including how many family members are included:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Rate your parents marriage:

Unhappy _____

Average _____

Happy ____

Very Happy___

As a child, did you feel closest to your father (Yes __), mother (Yes__), or another (Who? _______________)?
Rate your childhood:

Unhappy _____

How many Older brothers ____


Who disciplined you?

Average _____

Younger brothers ____

Father ___

Mother ___

Happy ____

Very Happy___

Older sisters ____

Younger sisters____

Were they strict?

Yes ___

No___

HEALTH INFORMATION
Rate your physical health:

Very Good ___

Good ___

Average ___

Recent weight changes:

Lost: ________

Gained: __________

Declining ___

List all important present or past illnesses, injuries or handicaps: ____________________________________


________________________________________________________________________________________
Date of last medical examination _________________

Report Results ____________________________

Have you recently had a medical examination especially with marriage in mind? ________________________
Have you used drugs for other than medical purposes? Yes ___ No ___ What kind? ___________________
Are you presently taking medication? Yes ___ No ___ What kind? __________________________________
Have you ever had a severe emotional upset? Yes ___ No ___ If so, when was the latest? ______________
Have you ever had psychotherapy or counseling? Yes ___ No ____

When? _____________________

Do you have any fears or worries concerning health? Yes ___ No ____ What are they? _________________
Do you have any physical or emotional concerns? Yes ____ No ____

What are they? ________________

SEXUAL EXPECTATION
Have you had any previous sexual experience? Yes ___ No ___ When? _____________________________
If so, does your fianc know of them?

Fully _____

Partially ____ Not at all _________

Have you or are you living together? __________________________________________________________


Have you discussed standards on your physical relationship before marriage? Yes ___ No _____
If so, what is this standard? __________________________________________________________
_______________________________________________________________________________________
What are your parents ideas on this matter? ____________________________________________________
________________________________________________________________________________________

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Is your fiancs interest in sex different from yours? Yes ___

No ____

How, specifically? (Frequency/Type) ____________________________________________________


In discussing your sexual expectations with one another, what, if any, are your concerns? ________________
_______________________________________________________________________________________
________________________________________________________________________________________
CHILDREN & PARENTING
Have you discussed family planning? Some ____

None ____

Quite thoroughly ______

How will you raise your kids in the same manner as your parents? ___________________________________
________________________________________________________________________________________
How will you raise your kids differently than your parents? _________________________________________
________________________________________________________________________________________
What goals have you discussed together regarding having and raising children? ________________________
________________________________________________________________________________________
________________________________________________________________________________________
FINANCES
What is your fiancs attitude toward finances? __________________________________________________
________________________________________________________________________________________
What is his/her habit with money? ____________________________________________________________
What type of specific plan have the two of you discussed for how to manage your finances? ______________
________________________________________________________________________________________
COMMUNICATION
Are there any issues you wonder whether you should tell your fianc? Yes ______

No ________

When it comes to communication, what do you like about your fiancs style? (Keep in mind that how they
communicate now is how they will communicate after marriage as well)__________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

How are disagreements and conflict best resolved between you and your fianc? (Briefly describe) ______________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________

What is the method your fianc uses to resolve conflict? ___________________________________________


In what areas do you find you have the greatest disagreements? ____________________________________
________________________________________________________________________________________
Does your fianc know you disagree on these things? Yes ______ No ______ Somewhat ________
In what ways are your lifestyles, backgrounds and opinions similar? __________________________________
________________________________________________________________________________________
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In what ways are your lifestyles, backgrounds and opinions different? ________________________________
________________________________________________________________________________________
What are some behaviors you like about your fianc? _____________________________________________
________________________________________________________________________________________
What are some behaviors you dont like? _______________________________________________________
________________________________________________________________________________________
Can you live with or without these behaviors? Explain. ______________________________________
__________________________________________________________________________________
MARRIAGE EXPECATIONS
What are your views of the roles of the husband and of the wife respectively?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
What are the responsibilities of a spouse and of a parent respectively? _______________________________
________________________________________________________________________________________
________________________________________________________________________________________
OTHER CONCERNS
Is there any pressure to get married, either by someone or some circumstance? Yes ____ No ______
What are the career plans for each of you once you are married? ___________________________________
_______________________________________________________________________________________
What are some of the challenges you are facing in relation to friends and family members in regard to your
marriage? ______________________________________________________________________________
________________________________________________________________________________________
As you approach marriage, what would be the greatest challenge that you believe you will be facing as
husband and wife? ________________________________________________________________________
What activities does your fianc enjoy the most and what would prevent you from fulfilling these activities after
marriage? _______________________________________________________________________________
_______________________________________________________________________________________
Do you desire to be married by a pastor from New Life? ___________________________________________
Who? 1st Choice ________________________________ 2nd Choice ________________________________
How will you handle holidays between your families? _____________________________________________
What kinds of traditions surrounding holidays, meal times, and vacations etc. will you establish? ___________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
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HUSBAND & WIFE ROLE CONCEPTS


What do you believe about your role in marriage?
To be filled out individually. Please also rate how you believe your fianc will score each item.
Numeric Guidelines:

1. Strongly agree

2. Mildly agree

3. Not sure

4. Mildly disagree

5. Strongly disagree

How You Believe


Your Fianc
Would Respond

Your Response
1

The husband is the head of the home.

The wife should not be employed outside of the home.

The husband should help regularly with the dishes.

The wife has the greater responsibility for the children.

Money that the wife earns is her money.

The wife should always be the one to cook.

The husband should have at least one night a week out with friends.

The husband's responsibility is to his job and the wife's responsibility


is to the home and children.

Money can best be handled through a joint checking account.

Marriage is a 50-50 proposition.

Major decisions should be made by the husband in case of an


impasse.
The husband should babysit one night a week so the wife can get
away and do what she wants.

A couple should spend their free times with one another.

It is alright for the wife to initiate love-making with her husband.

The husband and wife should manage money matters together.

Neither the husband nor the wife should purchase an item costing
over thirty dollars without consulting the other.

The father is the one responsible for disciplining the children.

A wife who has a special talent should have a career.

It is the wife's responsibility to have the house neat and clean.

The husband should take his wife out somewhere twice a month.

The wife is as responsible for the children's discipline as the husband.

It is the husband's job to do the yard work.

The mother should be the teacher of values to the children.

Women are more emotional than men.

Children should be allowed to help plan family activities.

Children develop better in a home with parents who are strict


disciplinarians.

The wife should always obey what her husband asks her to do.

The husband should decide who is responsible for each area.

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Neither husband nor wife should invite their parents into the home
without the other's permission.

Concerning the following areas, how would you rate yourself on a scale of 1 to 10
(with 10 being the most positive):

_____ Communication
_____ Resolving conflict

_____ Managing money


_____ Commitment to Christ

*PLEASE NOTE*
Completion of the pre-marital counseling does not necessarily mean that New Life will endorse your
marriage, or that one of our pastors will perform your wedding ceremony. Since endorsement of your marriage
is given near or after your counseling is completed, New Life Church is not obligated to meet any wedding date
set prior to counseling. Our sincere desire is that God will richly bless your lives.
Please complete two copies of this form one for the prospective groom and one for the prospective bride.
After you have completed these forms, please mail the forms to New Life Church, 2690 Bishop Drive, Suite
250, San Ramon, CA 94583, or you may email these forms to nlcoffice@newlifeinfo.com. You will be
contacted by the Pastoral Care staff regarding your availability or you may call us at (925) 399-9200.
Prospective Grooms e-mail address: __________________________________________________________
Prospective Brides e-mail address: ___________________________________________________________

Signature ________________________________________________________
Date Questionnaire Completed ______________________

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SCRIPTURAL GUIDELINES
FOR ALL PERSONS CONSIDERING REMARRIAGE
To aid the staff of New Life Church, each person contemplating remarriage following divorce must fill
out this form. The form must be turned in to the office before any counseling sessions can be
established, or before the wedding can be placed on the church calendar.
JUSTIFICATION FOR REMARRIAGE AFTER DIVORCE
1. When the marriage and divorce occurred prior to salvation (II Corinthians 5:17). Then the
clause in I Corinthians 7:39 must prevail, must belong to the Lord (this means no believer
should marry an unbeliever).
2. When ones mate has been guilty of sexual immorality and is unwilling to repent and live
faithfully with the marriage partner (Matthew 19:9). It is always wise to seek healing and
reconciliation even when this has occurred, but if there is no willingness on the part of the
guilty party to reconcile, the other party is free to remarry in the Lord.
3. When one of the mates is an unbeliever and willfully and permanently deserts the believing
partner (I Corinthians 7:15).

After carefully reading the above, please give a summary of your situation stating how it fits into one
of the above Scriptural principles.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
(USE OTHER SIDE IF MORE ROOM IS NEEDED)

Name: ________________________________________________ Phone: __________________________


Address: ________________________________________________________________________________
________________________________________________________________________________________
CITY

STATE

When divorced: __________________

ZIP

________________________

DATE

DATE

When are you contemplating marriage: ________________


DATE

ATTENTION: This sheet may be shared with the entire pastoral staff for evaluation and decision on
the scriptural grounds for remarriage.
(If both parties have been divorced, photocopy this page for each person to fill out.)

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