Premarital Counseling Application

Application For
Pre-marital Support Assistance
For the Marriage Support Application Go HERE.

Please fill out the application form below and choose a service provider. Information about our service providers can be found here. Upon receiving your application, we will contact you within 48 business hours.

Today's Date

When are you getting mrried? If you he not selected a date put N/A

Contact Information

First name

Last name

Street Address

City

State

Postal / Zip code

Phone

Partner's Name

Partner's Email Address (please provide a differenet one from the applicant)

Demographic Information

Do you or your partner have children? Required

Yes, I do.

No, I don't.

Yes, my partner does.

Identity Verification

Indentifiction such as driver's license or state ID.

Upload File

Upload supported file (Max 15MB)

Proof of residency such a lease agreement or utility bill.

Upload File

Upload supported file (Max 15MB)

Select A Service Provider

Please let us know how you learned about KFM- Facebook, Interent search, or word of mouth (who or what agency).

I, the undersigned, hereby authorize the release of information to Kingdom Family Ministry board of directors for the purpose of determining program eligibility and monitoring program compliance.

Yes, I accept.

I, the undersigned, understand Kingdom Family Ministry is only providing assistance so couples can afford support for their marriages. Kingdom Family Ministry is not responsible for the selection of a service provider or the outcome of sessions with the service provider.