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Prayer & Rejoice Request Form
If you wish to be prayed for in person, please contact our Director of Care at 641-628-3493.
Your request is confidential.
If your request is urgent, please contact our church office at 641-628-3493.
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* Indicates required question
Name
*
Your answer
Email address (we won't share this)
*
Your answer
Type of prayer
*
Request
Rejoice
Prayer Content: Describe your prayer request, concern or rejoice below.
*
Your answer
Check all areas that coorespond with your request.
*
Death
Marriage
Divorce
Children
Prayer
Healing emotional
Healing physical
Financial
Rejoice
Other:
Required
Request Date
*
MM
/
DD
/
YYYY
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