Certification Of Completion Of Qualifying Premarital Education printable pdf download

Certification Of Completion Of Qualifying Premarital Education

CERTIFICATION OF COMPLETION OF QUALIFYING PREMARTIAL

EDUCATION

This will certify that ________________________________________ and

(Groom’s Name)

_________________________________________________ have completed a course of

(Bride’s Name)

premarital education conducted by the undersigned on

____________________________________________________________ and that

List ALL dates

(

)

course qualifies under Section 19-3-30.1 of the Official Code of Georgia Annotated in that it

included at least six hours of instruction involving martial issues (which may include but not

be limited to conflict management, communication skills, financial responsibilities, and extended

family roles) and the couple underwent the course together.

I further certify that I am

_____ A professional counselor, social worker, or marriage and family

therapist who is licensed pursuant to Chapter 10A of Title 43 of the Official Code of Georgia

Annotated;

_____ A psychiatrist who is licensed as a physician pursuant to Chapter 34 of Title 43 of the

Official Code of Georgia.

_____ A psychologist who is licensed pursuant to Chapter 39 of Title 43 of the Official Code of

Georgia Annotated.

_____ An active member of the clergy who:

_____ performed such education in the course of my service as clergy; OR

_____ designated ____________________ to perform such education, and I certify that my

designee is trained and skilled in premarital education, and has certified to me the completion of

the course by the couple.

Sworn to and certified before me

___________________________________

on ___________________, 20___.

Signature

___________________________

___________________________________

Notary Public

Printed Name

___________________________________

Address

___________________________________

City, State, ZIP

(This form is to be completed by the pastor/counselor who performed

the premarital education. The pastor/counselor must sign this form in

the presence of a notary public. The couple should present the

completed form when applying for the marriage license.)

Certification Of Completion Of Qualifying Premarital Education

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