Coaching Couple Application

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Husband's First Name
Wife's First Name
Last Name
Address
City
State
Zip
Home Phone
Husband Work Phone
Wife Work Phone
Husband Cell Phone
Wife Cell Phone
E-Mail
Husbands Birthdate
Wife's Birthdate
What is your Wedding Date?
How Many Time's Have You Been Married? (Husband)
How Many Time's Have You Been Married? (Wife)
Children's Names (Youngest to Oldest)
Children's Birthdates (Youngest to Oldest)