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Interview Agreement Forms
These are the Interview Agreement Forms submitted via your profile (& thus owned by you as the reconciler). Click one of the rows in the table to open and view a specific information form. Click another row to view another form.
Submission Time | First Name | Last Name | Email | Signature |
---|---|---|---|---|
09/13/2025 | lisa | franklin | lisafranklin53@hotmail.com | |
08/26/2025 | Fay | SOBOTTKA | FaySobottka42@gmail.com | |
08/25/2025 | Fay | SOBOTTKA | FaySobottka42@gmail.com | |
06/13/2025 | Mike | Smith | michael.garrick.smith@gmail.com | |
06/12/2025 | Sam | Keithley | agriefobserved@gmail.com | |
05/12/2025 | Alison | Smith | alison@stsconsulting.net | |
04/10/2025 | Sherilyn | Allen | sherilynallen@yahoo.com | |
04/09/2025 | Natalie | Eichenberger | natalieike@gmail.com | |
03/04/2025 | fred | flintstone | fred@gmail.com | |
01/24/2025 | Jennifer | Blanton | jcbj76@hotmail.com | |
01/05/2025 | Test | User | test2@hisaor.org | |
12/09/2024 | Melody | Johnson | mel.sjohnson@icloud.com | |
12/09/2024 | Travis | Formoso | tformoso@codpa.net | |
10/04/2024 | lisa | franklin | lisafranklin53.lf@gmail.com | |
09/06/2024 | Daniel | Kenyon | dankenyonmusic@gmail.com | |
08/27/2024 | Katie | Finch | katiefinch289@gmail.com | |
08/05/2024 | DAVID | TURNER | DGTURNER67@YAHOO.COM | |
06/07/2024 | Andrew | Strickland | astrickland@zionalex.org | |
06/05/2024 | Titus | Utecht | titus.utecht@gmail.com | |
06/05/2024 | Bill | Maroney | bmaroney@harvestnewbeginnings.com | |
06/05/2024 | Bill | Maroney | bmaroney@harvestnewbeginnings.com | |
06/05/2024 | Bill | Maroney | bmaroney@harvestnewbeginnings.com | |
05/01/2024 | HOLLY | NICHOLSON | hollyknick@gmail.com | |
04/05/2024 | Heather | Kreiser | heather.kreiser@gmail.com | |
02/29/2024 | Michael | Sunseri | pastorsunny375@gmail.com | |
02/29/2024 | Michael | Sunseri | pastorsunny375@gmail.com | |
02/13/2024 | Adam | Finch | adam388@gmail.com | |
01/08/2024 | Alexander | Knowles | zknowles.sc@gmail.com | |
11/30/2023 | Dwight | Schettler | dwight@aorhope.org | |
10/24/2023 | Christopher | Vazquez | vazquezce29@icloud.com | |
09/29/2023 | John | Munch | jmunch50@gmail.com | |
09/28/2023 | Beth | Kopadt | beth21082gl@gmail.com | |
09/07/2023 | Daniel | Person | djperson74@gmail.com | |
08/15/2023 | Erik | Ronnegard | eronnegard@svt.org | |
08/15/2023 | Erik | Ronnegard | eronnegard@svt.org | |
06/13/2023 | gail | ploetz | gailploetz@gmail.com | |
06/09/2023 | Chris | Clarke | sendmenojunkmailok@yahoo.com | |
05/16/2023 | Isis | Palacios | ipalacioscartin@dorchester2.k12.sc.us | |
04/20/2023 | Haniel | Gray | grayhl@icloud.com | |
04/14/2023 | Alexandria | Shick | dcsalex@rlom.org | |
02/19/2023 | Brielle | Brenner | brielleesposito@gmail.com | |
08/31/2022 | Norma | Walker | info@ganonglaw.com | |
08/28/2022 | Sean | Benson | digshakespeare@gmail.com | |
08/26/2022 | Karen | Morgan | kmorgan@northwoodacademy.com | |
08/08/2022 | Chad | Bailey | chad@ccbaileyco.com | |
05/29/2022 | Wilma | Flintstone | wilma@yahoo.com | |
05/29/2022 | B | R | br@gmail.com |
Personal Information Forms
These are the Personal Information Forms submitted via your profile (& thus owned by you as the reconciler). Click one of the rows in the table to open and view a specific information form. Click another row to view another form.
Submission Time | First Name | Last Name | Email |
---|---|---|---|
06/25/2025 | Ryan | Bajema | ryanbajema@gmail.com |
06/12/2025 | Samuel | Keithley | agriefobserved@gmail.com |
06/11/2025 | Tara | Bajema | tarabajema@gmail.com |
05/12/2025 | Alison | Smith | alison@stsconsulting.net |
03/04/2025 | fred | flintstone | fred@gmail.com |
01/24/2025 | Jennifer | Blanton | jcbj76@hotmail.com |
01/05/2025 | Test | User | test2@hisaor.org |
12/09/2024 | Travis | Formoso | tformoso@codpa.net |
10/06/2024 | lisa | franklin | lisafranklin53@hotmail.com |
06/07/2024 | Andrew | Strickland | astrickland@zionalex.org |
04/05/2024 | Heather | Kreiser | heather.kreiser@gmail.com |
02/29/2024 | Michael | Sunseri | pastorsunny375@gmail.com |
01/11/2024 | David | Jamar | kennethj@gojbar.com |
01/08/2024 | Alexander | Knowles | zknowles.sc@gmail.com |
10/24/2023 | Christopher | Vazquez | vazquezce29@icloud.com |
09/29/2023 | John | Munch | jmunch50@gmail.com |
09/28/2023 | Beth | Kopadt | beth21082gl@gmail.com |
09/07/2023 | Daniel | Person | djperson74@gmail.com |
08/15/2023 | Erik | Ronnegard | eronnegard@svt.org |
06/13/2023 | gail | ploetz | gailploetz@gmail.com |
05/16/2023 | Isis | Palacios | ipalacioscartin@dorchester2.k12.sc.us |
08/31/2022 | Norma | Walker | info@ganonglaw.com |
08/26/2022 | Karen | Morgan | kmorgan@northwoodacademy.com |
08/08/2022 | Chad | Bailey | chad@ccbaileyco.com |
08/04/2022 | Brad | Bailey | brad@bsbco.net |
05/29/2022 | Betty | Rubble | betty@gmail.com |
05/29/2022 | Wilma | Flintstone | wilma@gmail.com |
05/29/2022 | Wilma | Flintstone | fred@gmail.com |
05/29/2022 | B | R | br@gmail.com |
05/09/2022 | fred@gmail.com |
Preliminary Statement of
Issues and Remedies Forms
These are the Preliminary Statement of Issues and Remedies Forms submitted via your profile (& thus owned by you as the reconciler). Click one of the rows in the table to open and view a specific information form. Click another row to view another form.
Submission Time | First Name | Last Name | Email |
---|---|---|---|
08/26/2025 | Fay | SOBOTTKA | FaySobottka42@gmail.com |
06/25/2025 | Ryan | Bajema | ryanbajema@gmail.com |
06/12/2025 | Sam | Keithley | agriefobserved@gmail.com |
06/11/2025 | Tara | Bajema | tarabajema@gmail.com |
03/04/2025 | amandajoycantu714@yahoo.com | ||
03/04/2025 | Amanda | Cantu | amandajoycantu714@yahoo.com |
03/04/2025 | Amanda | Cantu | amandajoycantu714@yahoo.com |
02/01/2025 | Terence | Johnson | terejohnson@me.com |
01/24/2025 | Jennifer | Blanton | jcbj76@hotmail.com |
01/22/2025 | Kevin | Cook | kcook7896@gmail.com |
01/22/2025 | Kevin | Cook | kcook7896@gmail.com |
01/05/2025 | Paul | Mueller | pmemueller@gmail.com |
01/05/2025 | Paul | Mueller | pmemueller@gmail.com |
12/09/2024 | Travis | Formoso | tformoso@codpa.net |
10/04/2024 | lisa | franklin | lisafranklin53.lf@gmail.com |
07/22/2024 | Bridget | Gausman | bridget.gausman@icloud.com |
06/10/2024 | Bryan | Barrett | bryanbarrett@gmx.com |
06/07/2024 | Andrew | Strickland | astrickland@zionalex.org |
04/04/2024 | Heather | Kreiser | heather.kreiser@gmail.com |
04/04/2024 | Heather | Kreiser | heather.kreiser@gmail.com |
02/29/2024 | Michael | Sunseri | pastorsunny375@gmail.com |
02/02/2024 | Kimberly | McAllister | friendofsingers@gmail.com |
02/02/2024 | Kimberly | McAllister | friendofsingers@gmail.com |
01/17/2024 | Shawn | Robey II | shawnrobeyii@yahoo.com |
01/17/2024 | Shawn | Robey II | shawnrobeyii@yahoo.com |
01/08/2024 | Alexander | Knowles | zknowles.sc@gmail.com |
10/24/2023 | Christopher | Vazquez | vazquezce29@icloud.com |
09/29/2023 | Beth | Kopadt | beth21082gl@gmail.com |
09/07/2023 | Daniel | Person | djperson74@gmail.com |
09/02/2023 | FredIpad | flintstone | fred@gmail.com |
09/02/2023 | fred | flintstone | fred@gmail.com |
09/01/2023 | Summer | Alvarado | summer.j.alvarado@gmail.com |
09/01/2023 | Summer | Alvarado | summer.j.alvarado@gmail.com |
08/15/2023 | Erik | Ronnegard | eronnegard@svt.org |
06/22/2023 | gail | ploetz | gailploetz@gmail.com |
06/09/2023 | Chris | Clarke | sendmenojunkmailok@yahoo.com |
05/16/2023 | Isis | Palacios | ipalacioscartin@dorchester2.k12.sc.us |
11/10/2022 | Christopher | Lorenz | archbuilder1@gmail.com |
09/01/2022 | Norma | Walker | info@ganonglaw.com |
08/26/2022 | Karen | Morgan | kmorgan@northwoodacademy.com |
08/08/2022 | Chad | Bailey | chad@ccbaileyco.com |
08/04/2022 | Brad | Bailey | brad@bsbco.net |
08/04/2022 | Brad | Bailey | brad@bsbco.net |
08/04/2022 | Fred | fred@gmail.com | |
06/29/2022 | Sumner | Murray | sumnerthemurray@gmail.com |
06/29/2022 | Sumner | Murray | sumnerthemurray@gmail.com |
06/02/2022 | Katherine | Miller | katherinemiller3777@gmail.com |
05/29/2022 | B | R | br@gmail.com |
Personal Information Form
Are you sure? This is not reversible.
We have been married for 24 years and separated the past 6 months since my sin was exposed.
Attorney Information
I have elders from our church and close friends and pastors giving me counsel.
Religious Background
Strong faith- grew up in church
This has been a time when the gospel has become real to me, understanding grace, forgiveness and what God truly calls me to.
Gods Word is perfect- authoritative and given to us to outline how we are to live and the decisions we are to make and to daily transform us more into the likeness of Jesus.
Who, if anyone, has had the most influence on your religious or spiritual life? (Please give names and relationships)
Pastor Mike Kirkelie- friend and mentor
Jerry Roosma- friend and elder
Kurt Langstraat- friend and pastor
Tim Boersma- friend and purity accountability
Other Party Information
Interview Agreement
Are you sure? This is not reversible.
Thank you for your interest in reconciliation. Our goal is to help guide Christians involved in conflict to remember their reconciliation with God and to reconcile with one another as children of God (2 Corinthians 5:16-21). This Interview Agreement sets forth our mutual expectations for using our reconciliation services, including an initial consultation.
We believe that the Bible provides thorough guidance and instruction for faith and life (2 Timothy 3:16- 17). Therefore, beginning with what God has done for us through Christ, we base our services on scriptural principles rather than those of secular psychology or psychiatry. God’s Word urges us to live in peace with each other by promoting understanding, personal responsibility, justice, and reconciliation (Romans 12).
All of our services are provided according to the Rules of Procedure found in Guidelines for Christian Conciliation published by the Institute for Christian Conciliation. The Rules are incorporated in this agreement by reference as set forth in their entirety. (You can view the Rules online at https://www.aorhope.org/rules)
Not Legal Representation – Christian reconciliation may be used to resolve legal disputes (Matthew 5:23- 26; 18:15-20; 1 Corinthians 6:1-8). Even so, our reconcilers do not provide the kind of legal advice and advocacy that can be obtained through a personal attorney. We work with and for all of the people in a dispute helping them to find a mutually satisfactory agreement. Therefore, if you are concerned about your legal rights, you should consult with an independent attorney who would be willing to accompany and advise you, if you deem it necessary, during the reconciliation process.
Fees – There is no fee charged for a 30-minute initial consultation. After initial consultation, our standard reconciliation fees will apply.
Confidentiality is an important aspect of the conciliation process and we will carefully guard the information you entrust to us. However, we may need to divulge information to appropriate authorities if there is a clear indication that someone might otherwise be harmed (see Rules of Procedure 16 and 17). You agree not to discuss our communication with people who do not have a necessary interest in the reconciliation process. By participating in this process, you agree to treat all dealings with us in regard to this dispute as settlement negotiations, which means they will be inadmissible in a court of law or for legal discovery. Furthermore, you agree that you will not try to force any reconciler to divulge any information acquired during reconciliation or to testify in any legal proceeding related to this dispute.
Our Commitments to You – We desire that parties be given the opportunity to tell their story in a safe environment and to lay their burden at the foot of the cross. To that end we will:
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Listen with caring, compassionate concern, seeking to understand and to be supportive.
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Provide you with the opportunity to tell us what is needed for healing and restoration.
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Bring the Gospel to bear as we have opportunity, including confession and forgiveness.
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Provide biblical coaching to help you live out your vocation as children of God in your disputes.
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Keep confidences, only reporting to authorities what is appropriate or required by law (see above on confidentiality).
Briefly describe how we may serve you:
marriage reconciliation

Preliminary Statement of
Issues and Remedies
Are you sure? This is not reversible.
Describe your dispute or conflict in three of four sentences:
Our Pastor does not agree with nor adhere to either the LCMS standard for Voters Assembly governed congregations or our Constitution and By Laws which clarify how we execute our Voters Assembly governed congregation. He has never engaged, been accountable to, or worked in cooperation with the Elders and he has never accepted the leadership and administrative tasks that I execute as the duly elected Church Council President.
What do you want your reconcilers to do?
Assist the Pastor, Council President, and Elders in developing an action plan to approve communication and accountability so that we can continue to serve the congregation to the glory of God.
The questions to be answered in conciliation are:
How do we resolve this conflict. What is the way forward.
The claims and remedies I seek are:
Peace, harmony, communication, accountability, cooperation, unity, effective service in our specific roles.