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P.R.O.M. 2012 Registration Form
* Required Field
*Date Married  (month/day/year)
 *What Church Do You Attend (optional)
*Husband and Wife's first and last name:
*Are You Celebrating a Special Event?
*Address
 *City
 *State
 *Zip Code
*Contact number
 Alternate number(s)
 *Email Address Wife
*Email Address Husband
_______________________________________________________________________________________________________________________________________________________________________________
*Package Type:
Please check one
*Payment Type:
Please check one
(All payments are
non-refundable.)
You will be directed to Paypal
once you hit the Submit Button
Debit/ Credit Card
P.R.O.M. Only
_______________________________________________________________________________________________________________________________________________________________________________
Music Style Interests
Couples' Favorite Song and Artist
How Did You Hear About P.R.O.M.
_______________________________________________________________________________________________________________________________________________________________________________
* PLEASE NOTE: NOMINATION FOR ONE FLESH IMAGE AWARDS IS NOT REQUIRED TO REGISTER FOR P.R.O.M.  *
*  ONE FLESH IMAGE AWARDS NOMINATION  *
*There will be 3 final nominees selected from each category. You must be registered for P.R.O.M. to be
considered as a nominee. You may nominate or be nominated in more than one category.
WE WILL SEND FAMILY AND FRIENDS TO THE SITE TO NOMINATE US
WE WILL NOMINATE OURSELVES FOR A ONE FLESH IMAGE AWARD
Use the space below to submit how you best exemplify one or more of the One Flesh Image Categories. Spread
the word, and have others support you by clicking the NOMINATION BUTTONS on previous page. *Support is not
required in order to be considered as a final nominee.
Reason for nomination:
Selected Category:
If paying by Credit Card or Debit Card, please use the PayPal buttons below
to make payments to confirm your registration online.  
Please Note, All Payments
after registration are
non-refundable.
$125-P.R.O.M. Only
Reflects One Flesh in
Communication









This award is presented to the couple that
speaks one voice and presents a
communication style that displays love,
respect, & honesty towards one another.
Reflects One Flesh in
Service










This award is presented to the couple
that displays a spirit of serving to each
other and/or to others in their home,
church, or community.
Reflects One Flesh in
Love & Affection











This award is presented to the couple
that are examples in displaying
love & affection.
Reflects One Flesh in
Coordinating Fashion & Style












This award is presented to the couple
that makes a fashion statement usually
by color coordinating or complimenting
each other with their fashion style.
Reflects One Flesh in
Refreshing Spirit









This award is presented to the couple
that displays a refreshing personality
and renews others with their spirit.
Proverbs 11:25
Reflects One Flesh in
Raising Children &
Legacy Building








This award is presented to the couple
that displays unity and support when
raising their children, and intentional
techniques in achieving desired results
for their children and family.
Reflects One Flesh in
Marriage Made Fun










This award is presented to the couple that
displays marriage as a fun institution.
Reflects One Flesh in
Working Together











This award is presented to the couple
who is known for effectively working
together in ministry or business.
Reflects One Flesh in
Growing Together









This award is presented to the couple  
that allows and encourages each
other to grow, and continues to the go
to higher levels in various
areas of life together.

Reflects One Flesh in
Unity









This award is presented to the couple
who reflects that their spouse is number
one in their life and they refer to one
another in decision making. (This couple
allows the Holy Spirit to speak through
others, while not allowing other’s
convictions to govern their marriage.)
Reflects One Flesh with a
Unique Connection









This award is presented to the
couple who displays they are
connected spiritually and
emotionally, and a sense of
understanding of one another.

Reflects One Flesh in
Healthy Living











This award is presented to the couple
whose marriage can be described the
same way both publicly and privately. This
couple strives, together, to live a life style
that promotes mental, physical, and/or
spiritual health. (The couple can be
nominated if striving for healthy living in
one or all of these areas. For example
exercising, healthy eating, emotional &
spiritual enhancement activities)
The 12 Categories for One Flesh Image Awards
How Do You Reflect the One Flesh Image?
REGISTRATION FORM BELOW.  Also think of a couple you can nominate for one or more of these
One Flesh Image Categories. Nominate and invite them to P.R.O.M.
Back to P.R.O.M.
We Look Forward to Enjoying a
Fabulous Evening With You
Should you have any difficulty registering
on-line please contact us at 708-367-1589