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Member Profile

Please complete your membership profile. All of the requested information will be kept in the strictest of confidence and will not be used for ANY purposes other than those required for participation on the FAM Fellowship website and to give us a better understanding of our members' needs as we strive to address them.

Required fields are marked in red

Username:(used for login)		Display Name:(displayed on site-given first names only-assumed name may be used)
Email (you must supply a valid email address):
First Name:		Last Name:
Street Address:
City:	State/Province:  N/A Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Virgin Islands American Samoa Guam Alberta British Columbia Manitoba New Brunswick Newfoundland & Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon	Zip/Postal Code:		Country:
Phone:		Your Age:
How did you hear about us?:
Brief Description Of Marital Status (how long married, separated or divorced, etc.):
Is An Adulterous Relationship (AR) Involved And By Whom:
Describe Current Relationship With Spouse (no contact, friendly, angry, etc.):
Number Of Children And Their Ages And Custody Status:
Briefly Describe Your Relationship With The Lord:
Describe Bible Study And Prayer Habits:
Describe Church Participation And Which Denomination:
Do you see yourself as a victim? No Answer Yes No
Do you recognize any wrong doing or mistakes on your part? No Answer Yes No
Do you understand or know why your spouse left or wants to leave (or what his/her issues are)? No Answer Yes No
Have you forgiven your spouse? No Answer Yes No
Has your spouse forgiven you? No Answer Yes No
Have you had any kind of counseling? No Answer Yes No
Do you participate in "singles" activities? No Answer Yes No
Are you committed to the restoration of your marriage? No Answer Yes No
Do you ever doubt the restoration of your marriage? No Answer Yes No

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