Relationship Growth Academy Interest Form

Partner 1 Name:

Partner 2 Name:

Email *

Phone *

Length of Relationship

City

Do you have children? If yes, how many?

Are both partners open and willing to engage in coaching?

Yes

If no, please share any hesitancy.

Marital Status

Married

Engaged

Living Together

Dating

Have you previously attended any form of relationship counseling or workshops?

Yes

What areas of your relationship would you like to improve or focus on?

What prompted you to seek help at this time?

How do you prefer to learn and grow within the program? (Workshops, one-on-one counseling, group sessions, reading materials, interactive activities, etc.)

Are there any specific topics or areas you're particularly interested in exploring during the program?

Please indicate your general availability for sessions: (Weekdays, weekends, mornings, afternoons, evenings)

Is there anything else you would like us to know about you as a couple of individuals?

I agree to terms & conditions provided by Affinity Alliance. By providing my phone number, I agree to receive text messages from Affinity Alliance.