Prayer Quilt Request

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To request a Prayer Quilt, please fill out this form in its entirety.

Prayer Quilt Requested By (please include first and last name) *

Phone Number *

Prayer Quilt Requested For (please include first and last name) *

Phone Number *

Address *

How will the quilt get to the recipient? *

I will deliver the quilt myself (PICK UP IN CHURCH OFFICE)

The quilt recipient will pick up the quilt themselves (PICK UP IN CHURCH OFFICE)

I would like the Prayer Quilt Ministry to deliver the quilt for me (LOCAL ONLY)

I would like the Prayer Quilt Ministry to mail the quilt for me (NON-LOCAL ONLY)

Prayer Request *

Scripture *

Quilt Material Preference *

Cotton

Fleece

Quilt Type Preference *

Standard Quilt

Patriotic Quilt for Veterans

Breast Cancer Quilt

Other:

Quilt Color Preference *

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