Pray for Me
Thank you for contacting us about your prayer concerns. Please fill out the following information so we can better assist you.
Please Note: If you have any trouble filling out and/or submitting this application you may also send your prayer request to: email@example.com
Location of person needing prayer: City and State, Province/Country
Please let us know what your prayer concerns are:
URGENT HEALING/MIRACLE NEEDED
Raise the Dead
Baptism of the Holy Spirit
Please explain "Other":
Name(s) of person or people needing prayer:
International Phone Number
Prayer Request: Please give us a brief description of your prayer request:
Is the person in need aware that prayer has been requested for them?
Does the person in need want to be contacted for prayer?
If so, how would the person like to be contacted?
The person does not want to be contacted simply wants a prayer to be made.
If by phone or Skype, please give the best time and day to call.
For Skype calls, please provide us with the Skype ID as well.
If by email, what is the persons email?
Your location: City, State, Province/Country
What is your relation to the person in need?
I am requesting prayer for myself.
No relation, I am submitting on behalf of a friend or relative that knows the person.
Do Not Fill This Out