E-Fellowship Request

This is the request form for the e-fellowship program.  For more information about the program, please see our e-fellowship page. 

After we receive your form responses, we will look for another person (of same gender) that seems to be a good match for you based on the length of marriage, relationship with God and the details of your spouse's situation.  From that point on, you and your friend are free to correspond as you wish. 

All information you provide will be regarded as confidential.

First Name (required):   

Last Name or Initial (required):   

Email address:   

**Please double check that you have entered your email address correctly!

Gender:    Male    Female

Age:   

Marital Status:    Single    Married    Separated   Divorced

Spiritual situation: I am not a Christian    I am a Christian   

What country do you live in?

How long have you been married?

In the space below, please tell us about (required):

 (1500 characters max, please (~ 3 paragraphs)-  thank you)

How often would you like to correspond with your e-fellowship partner?

Daily    Twice a week    Weekly   

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