Palm Springs SDA Prayer List Request Form
Please complete this form as completely as possible.  Please note the following:

-  Requests are honored until the end of the month, then all names are removed.
-  Individuals may request to be reinstated every month.
-  Contact info is necessary will be used to connect with you by one of our pastors.
-  May God bless you each and every day.
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Email *
Today’s Date
MM
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DD
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Name of person requesting Prayer
Full Name of person on prayer list
Local Address
Phone Number
e-mail address
Reason for Prayer Request
Request a Pastor Visit? *
Include their Name on Newsletter? *
Permission granted to inform others of prayer request besides the pastor. *
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