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Resilient Marriage 3-Day Intensive
DO NOT fill out an application for your spouse. Each person must fill out his/her own application.
By completing this application YOU are attesting that YOU are the person named below.
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Application
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www.HopeRayTherapy.com
First & Last Name:
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Your answer
Age Today:
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Your answer
Email:
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Your answer
Phone Number:
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Your answer
Address:
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Your answer
How did you learn about the Resilient Marriage Intensive?
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Your answer
Please briefly describe the culture in which you were raised as well as where you were raised:
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Your answer
Partner's name:
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Your answer
Partner's age today:
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Your answer
How long have you been in your current relationship?
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Your answer
Do you have any children?
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Yes
No
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