Prayer Request Form
Let's commit to praying together.
Matthew 6:9-13
In this manner, therefore, pray: Our Father in heaven, Hallowed be Your name. Your kingdom come. Your will be done On earth as it is in heaven. Give us this day our daily bread. And forgive us our debts, As we forgive our debtors. And do not lead us into temptation, But deliver us from the evil one. For Yours is the Kingdom and the power and the glory forever. Amen.
Full Name
First Name
Last Name
Phone Number
Email
example@example.com
Who are we praying for?
Please Select
Myself
Friend
Family Member
Other
Section 1: Prayer for God's will in our community/neighborhood/cities/nation over:
*
General Request
Violence, Shootings
Salvation- Accepting Jesus
Biblical Understanding
Comfort- Recovery
Work- Employment, creating jobs
School-Prayer, Christian doctrine
Drugs
Depression, Suicide
Defeating Witchcraft, Demonic Influence
Military/EMT/Law Enforcement/Legislatures
Confidential/Unspoken: An option for individuals who prefer not to share details but still want prayer support
Legal Justice/Christian Reform
Our Churches
Unity/Racial Reconciliation
Public Officials/EMT/Military/Fire-Rescue/Hospitals/City
Section 2: Check the conditions that you are seeking personal prayer for or someone you know:
*
General Request
Physical Health- Healing, Recovery, or Well Being, Past Trauma
Emotional-Inner Healing, Past Trauma, Emotional Strength, The Mind
Salvation- Accepting Jesus
Biblical Understanding- Request for the Holy Spirit to provide understanding, Spiritual growth
Family- Godly dating, marriage, relationships, safety, or specific needs, children.
Comfort- Grief Recovery, Divorce Recovery, Recovery
Work- Employment, Work Concerns, studies, or vocational concerns
School
Community/World
Thanksgiving:-Gratitude and thanksgiving for answered prayers or blessings in our lives
Depression, Psychiatric disorder, Suicide
Witchcraft, Demonic Influence
Confidential/Unspoken: An option for individuals who prefer not to share details but still want prayer support
Legal Justice
Debt/Financial Wellness
Any other information you are willing to share that you feel is relevant for the prayer.
Do you have personal relationship with Jesus?
*
Please Select
Yes
No
Not sure
I don't understand
If you pick any answer apart from YES above, will you like to discuss further on that question?(Note your response to this question has nothing to do with either we are praying for you or not)
*
Yes
No
Prefer not to answer
Not decided
Not sure
Would you like us to follow up with you by phone or email after praying over your concern?
Please Select
Yes
No
Would it be okay to post your prayer on our webpage or networks for collective prayer?
Please Select
Yes
No
Confidentiality/Disclaimer
The information provided will be treated with utmost confidentiality. No part will be printed or shared except on prior and express permission of the author. Any requests of a criminal nature or confessions of illegal activities should be handled discreetly and may require appropriate action, such as contacting authorities or seeking professional help. This ensures that the confidentiality of the prayer request process is maintained while also addressing any serious concerns that may arise.
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