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Groom's Premarital Inventory Form
Full Name:
BirthDate:
Telephone (Home):
Telephone (Work):
Religious Denomination:
Baptized?
Yes
No
Confirmed?
Yes
No
Church Attendance:
Frequently
Occasionally
Seldom
Never
Address:
Family Address:
Marital Status: Choose All That Apply
Married
Single
Divorced
Widow
Children (Names and Ages:
Children Baptized (Names):
Children Confirmed (Names):
Occupation:
Employment History (Last Three Years)
Education: Grade Completed:
Special Training or Course Work or Degree:
Health History: List health problems such as serious physical illness, retardation, mental illness, etc.
Family History
Mother's Name (Last, First, Maiden):
Mother Marital Status: Choose All That Apply
Married
Single
Divorced
Widow
Mother's Nationality:
Mother's Race:
Mother's Religious Denomination:
Mother's Occupation:
Mother's Education:
Mother's Health History:
Father's Name (Last, First):
Father Marital Status: Choose All That Apply
Married
Single
Divorced
Widow
Father's Nationality:
Father's Race:
Father's Religious Denomination:
Father's Occupation:
Father's Education:
Father's Health History:
Brothers and Sisters Names and Ages:
Good Shepherd Lutheran Church ~ 876 Grove St. ~ Conneaut, Ohio 44030 ~ Phone: 440-599-8908
Good Shepherd Lutheran Church is completely handicapped accessible!
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