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Premarital Questionnaire

2401 West Cypress Creek Road, Fort Lauderdale, FL 33309 954-977-9673

**Please complete and return to either:

Faith Roehm

Becky Jensen

Please check the appropriate class youll be attending:

____ Wednesday Night Class in Fort Lauderdale
____ at the Boca Raton Campus
____ at the Plantation Campus
____ Online Premarital
Name: __________________________________________________________________________ Date:
City: __________________________________________________ State: _________________________Zip:

Home: _ _____________ Work: _ ________________ Cell:_ _________________ Other:

E-mail Address:
Date of Birth: __________________ _ Name of your fianc:
Tentative Wedding Date (if any):
Location of wedding (if known):

You are probably about to begin the most important stage of your life MARRIAGE.
Marriage is a divine institution created by God, and it will be blessed
when there is obedience to His principles.
Please answer the following questions in a careful and prayerful attitude.
As you and your fianc work through this questionnaire (without consulting one another),
we trust that your present relationship will be strengthened and enriched as a prelude to a fulfilling
and growing marriage. We also hope that you will have a much more realistic perception of yourself,
your fianc, and your marriage in the Lord.
2 Revised 10.2009

Spiritual Background
A Christian is someone who has trusted in Jesus Christ to save them and forgive them of their sins.
Would you consider yourself to be a Christian?_____________________________________________________________
If yes, when and how did this take place?

When and where were you water baptized?
Please describe your walk with Jesus Christ since that time. 
How is the Holy Spirit working in your life right now? 
Is Calvary Chapel your home church?_ _________ How long have you been attending? 

Which Campus?
o Fort Lauderdale

o Boca Raton

o Hollywood

o Plantation

o Florida Keys

o Online

How often do you attend?

Are you presently attending another church?_______ Which one?

What are your personal spiritual habits?

Do you Pray? _______ How often? 
Do you regularly read the Bible? _______ How often? 
Do you regularly attend Church? _______ How often? 

Are you currently serving or involved in ministry of some kind? 

A Community Group or Christianity 101?
If yes, explain

Education / Employment
Highest educational achievement:
Future educational goals:
Present place of employment: _____________________________________________ How long?
Please explain your present position:

Please explain your career goals:

Present Family Life

Are you still living with your parents? _____________________________ Are they still married?
What lessons (good or bad) have you learned from their marriage?
Do you expect to repeat their successes/failures?
Discuss either:
Do they approve of your intended marriage partner?__________________________________________________________
If not, why? _________________________________________________ What is your response?

Are you presently living together? _____________________________ If yes, please explain why:

Previous Marriage(s)
Have you been married previously?_ ____________________________ If yes, how many times?______________________
(If more than once, please answer the following questions on separate sheets of paper for each marriage.)
Date of marriage:________________________________________________ Were you widowed? ______________________
If so, when did your spouse die? 
Date separated (if applicable):
Date of final divorce decree:
Why did this marriage fail?
Were either you or your ex-spouse born again Christians at this time? (Explain):

Has this ex-spouse remarried?_ ________________________________ Were there any children?______________________
If so, ages:
What are your childrens reactions to this proposed marriage?
Explain custody, visitation and child support arrangements:

Is child support current? (Be specific):
What classes/counseling have been initiated to assist you in the healing process from this divorce?

Personal Finances
Have you ever been arrested or convicted of a crime? ____________ If yes, please explain: 

Are you currently involved in any lawsuit? ____________________ If yes, please explain: 

How much financial debt will you be bringing into this marriage? (Include: car loans, credit cards, student loans, child support,
medical etc.): 

Do you presently owe any money to the IRS? ___________ If yes, how much? 

How long have you known each other? Are you engaged? __________
If so, how long have you been engaged? 
Are you sure this is true love? ____________ If yes, please describe why you believe it is:

Please describe your understanding of a Marriage Covenant or a Christian Marriage

What Bible studies have you participated in and which books have you read regarding Christian marriage?

What are your character strengths?
a) __________________________________________________________________________
b) __________________________________________________________________________
c) __________________________________________________________________________
What are your character weaknesses?
a) __________________________________________________________________________
b) __________________________________________________________________________
c) __________________________________________________________________________
What are your partners character strengths?
a) __________________________________________________________________________
b) __________________________________________________________________________
c) __________________________________________________________________________
What are your partners character weaknesses?
a) __________________________________________________________________________
b) __________________________________________________________________________
c) __________________________________________________________________________

What are your plans in regard to children? 
How many? _______________________________ When? 
Does the wife plan on working outside of the home? 
How will this affect the relationship/marriage? 
What do you expect from marriage? 
What does your partner expect from marriage? 
Do you have any fears or concerns about this relationship proceeding toward marriage? (Please describe):