Shores Baptist Worship Center

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(352) 687-1048

Request For Premarital / Marital Counseling

Type of Counseling Requested: *

Premarital (Attention Premarital Couples: This form must be turned in at least 4 months prior to your expected wedding date.)

Marital

Today's Date

Bride / Wife Name *

First

Last *

Last

Wedding Date:

Date Of Birth:

Email *

Home Phone Number *

Work Phone Number *

What is your preferred method of contact?

Current Address *

New Address

City *

State *

Postal Code *

Have you accepted Jesus Christ as your personal Savior? *

Yes

No

Any previous marriages? *

Yes

No

If yes, how many?

What was the cause of separation?

Windowed

Divorced

Are you a member of Fresh Wind? *

Yes

No

Number of Children?

Ages of your children? (Please separate by commas)

Are you under doctor's care? *

Yes

No

If yes, for what reason?

Groom / Husband's Name *

First

Last *

Last

Date Of Birth

Email *

Home Phone Number *

Work Phone Number *

What is your preferred method of contact?

Current Address *

New Address

City *

State

Postal Code *

Have you accepted Jesus as your personal Savior? *

Yes

No

Any previous marriages? *

Yes

No

If yes, how many?

What was the cause of separation?

Windowed

Divorced

Are you a member of Shores Baptist Worship Center? *

Yes

No

Number of Children?

Ages of your children? (Please separate by commas)

Are you under doctor's care? *

Yes

No

If yes, for what reason?

How did you hear about our services?

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Home
About
Education
Events
- Blog
Give
Live Stream
Contact Us
- SBWC Request Forms

Menu

Home
About
Education
Events
- Blog
Give
Live Stream
Contact Us
- SBWC Request Forms

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Shores Baptist Worship Center

414 Silver Rd. Ocala, Florida

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