Prayer Request Form

Prayer requests will be checked weekly. Concerns will be seen by Rev. Ed Briggs and Sandra McKee and will be followed up on.

Please note that names submitted for the bulletin/newsletter remain on the list for 30 days. Please resubmit your request if you would like for it to remain on the list, or let us know if you want it removed prior to 30 days.

Date: *

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Year20102011201220132014

Pray for: *

Member

Visitor

Family or friend

Submitted by:

Email Address:

Phone number:

Prayer Request Details for Pastors/Program Staff: *

I give permission to list my name only in the bulletin/newsletter.

I give permission to list his/her name only in the bulletin/newsletter.

Confidential prayer request.

Word verification: * (verify using audio)

Type the characters you see in the picture above; if you can't read them, submit the form and a new image will be generated. Not case sensitive.