Request Prayer

Please complete if you would like us to minister to you or somebody else.

Request Prayer

Name

First Name

Last Name

Email

What do you need?

Is this life or death?

Is this pertaining to a 24-hour life or death situation?

Who is this request for?

Would you like a prayer cloth?

If requesting HEALING or DELIVERANCE, would you like a prayer cloth?

Name of individual needing healing/deliverance or prayer.

If you are requesting this for somebody else, please tell us their name.

Where are you located?

If this is for somebody else, where are they located? (CITY, STATE, COUNTRY)

Address

*Only complete if you are requesting a prayer cloth. If you are requesting for somebody else, please provide their address instead of your own.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact preferences

1. If making this request for somebody else, do they know you are requesting prayer or healing/deliverance? 2. Would you like us to contact them in this regard?

Phone

(###)

###

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If you have been touched by this ministry, please share your testimony, so we may glorify Jesus.

Testimony

Name

First Name

Last Name

Email

Testimony

Provide your testimony of God's healing/deliverance through this ministry.

May we share your testimony?

May we share your testimony publicly to glorify God, His wonderful works, and His great mercy?