MARRIAGE MENTORSHIP WITH THE SAMS APPLICATION FOR BREAKDOWN TO BREAKTHROUGH MARRIAGE MENTORSHIP Questionnaire to assess the suitability of couples applying to be considered for Marriage Mentorship with The Sams. OK Question Title * 1. Your full name ...............................................................Your present occupation/business ................................................. OK Question Title * 2. Your contact information Email: Telephone (including country code) OK Question Title * 3. How many years have you been married? OK Question Title * 4. Do you have children? Please list their ages. If you have no children, please enter "0" OK Question Title * 5. What changes do you desire to see in your marriage? OK Question Title * 6. In your assessment, how did your marriage get to this point? What happened or did not happen? Please list addictions (if any) that have affected your relationship adversely? OK Question Title * 7. What have you done so far towards achieving the results you long for? What has worked? What has not? OK Question Title * 8. Which statement describes you the best? Should we be granted access to your mentorship: Both of us are totally committed to working together to produce a breakthrough. The wife is more committed than the husband. The husband is more committed than the wife. OK Question Title * 9. Which statement describes you the best? We are desperate for a breakthrough RIGHT NOW and are willing to invest the time, money and energy it takes to make it happen RIGHT AWAY. We know we need a breakthrough, but don't sense an urgency to do anything right away or invest in the process. OK Question Title * 10. How did you find out about our Mentorship? If someone referred you, please tell us their name and organization (if applicable) so we may express our appreciation to them. OK SUBMIT RESPONSE >>