PETITIONER:
*
FIRST NAME
LAST NAME
IF CAREGIVER REQUESTING & SIGNING FOR A PETITIONER:
FIRST NAME
LAST NAME
WHAT DO YOU WANT HEALED BY DAWN TOMORROW MORNING?
*
I ASK KING JESUS TO HEAL THE PETITIONER'S BODY
I ASK KING JESUS TO RESTORE THE PETITIONER'S DNA
I ASK KING JESUS TO MAKE ME THE PETITIONER'S IDEAL WEIGHT
I ASK KING JESUS TO HEAL THE PETITIONER'S MIND, WILL, & SOUL
I ASK KING JESUS TO BREAK EVERY CHAIN OF ADDICTION ON THE PETITIONER
ANY ADDONS OR EXCLUSIONS (LIKE GETTING FIXED, TATOOS, ETC...)?
DATE
*
-
Month
-
Day
Year
DATE
SIGNATURE
*
PLEASE VERIFY YOU ARE HUMAN
*
ENTER EMAIL FOR A PDF COPY TO BE SENT TO YOU:
*
example@example.com
SUBMIT PETITION
SUBMIT PETITION
Should be Empty: