Online Pre Marital and Marriage Blessings Classes Application Form

THIS APPLICATION IS BETWEEN :

First Name : (required)

Middle Name : (required)

Surname : (required)

Age (required)

P.O BOX

Mobile Number

Office Telephone Number

Physical Address

County

Sub County

Email Address

Occupation

Are you born again?
Yes No 

Tick as appropriate (Required)
Spinster Bachelor Widowed Single parent Marriage Blessing 

Fathers First Name :

Fathers Middle Name :

Fathers Surname :

If Father Not living, please indicate

Mothers First Name :

Mothers Middle Name :

Mothers Surname :

If Mother Not living, please indicate

Have you introduced your fiancée to your parents?
Yes No 

Do you attend ICC?
Yes No 

If No, Local pastor’s Name

Church Affiliation & Address

Are you a commissioned member of ICC?
Yes No 

If Yes, State membership Number

AND ....

First Name : (required)

Middle Name : (required)

Surname : (required)

Age (required)

P.O BOX

Mobile Number

Office Telephone Number

Physical Address

County

Sub County

Email Address

Occupation

Are you born again?
Yes No 

Tick as appropriate (Required)
Spinster Bachelor Widowed Single parent Marriage Blessing 

Fathers First Name :

Fathers Middle Name :

Fathers Surname :

If Father Not living, please indicate

Mothers First Name :

Mothers Middle Name :

Mothers Surname :

If Mother Not living, please indicate

Have you introduced your fiancée to your parents?
Yes No 

Do you attend ICC?
Yes No 

If No, Local pastor’s Name

Church Affiliation & Address

Are you a commissioned member of ICC?
Yes No 

If Yes, State membership Number