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Prayer Request V01
Requestor Information Information about the person submitting the request
First (*)
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Last (*)
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Address
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Home Phone Number
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Cell Phone Number
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Email (*)
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Request Information Information about the persons(s) concerned
First name of person to be prayed for (*)
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Last name of person to be prayed for (*)
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Relationship to requestor (ex: self, family member, coworker, friend/neighbor, etc)
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Is the Person
A Member of the congregation
A Non Member who attends regularly
Neither
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Specifics of the Prayer Request
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Topic of Request
Addiction and Recovery
Cancer
Children/Youth
Depression & Mental Health
Family & Relationships
Finances/Employment
Grief
Health & Healing
Hospice/End of Life
Spiritual Guidance
Surgery
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Please Have A Member of the Congregational Care Team Call Me (*)
yes
no
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This Request is Confidential (Pastors Only) (*)
yes
no
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If you worship with us, which service?
8:00
9:30
11:00
Other
None
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Click this button to submit your request
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