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S.C.C.R. Application
Thank you for taking the time to answer each question. We ask that you and your spouse complete the survey independently.
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What is your name?
Your answer
What's your spouse's name?
Your answer
How long have you been married?
Your answer
What is your Email Address?
Your answer
What is your phone number?
Your answer
What is your instagram handle?
Your answer
Are you and your spouse currently pursuing a divorce?
Yes
No
Clear selection
Have you been to a couples retreat before?
Yes
No
Clear selection
If yes, was it enjoyable? Explain.
Your answer
What are the top 4 things that you are looking forward to about this retreat?
Your answer
What are the top 4 things you like to do with your spouse at this retreat?
Your answer
What topics of discussion do you feel would have the greatest impact on your marriage?
Your answer
Do you consider yourself a Christian? Explain
Your answer
Are you comfortable in settings where conversations about Jesus Christ, the bible and prayer are taking place?
Yes
No
Sometimes
Clear selection
How often do you and your spouse get to hang out with other couples?
Very Frequently (Monthly)
Often (Bi Monthly)
Seldomn (2x/year)
Never (1x/year)
Are you comfortable in group settings?
All of the time
Sometimes
Never
Clear selection
How much do you enjoy game night with friends?
Booo! They Suck!
1
2
3
4
5
The Best Thing Ever!
Clear selection
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