Do you know of anyone who needs prayer? A family member? A co-worker? Even yourself?

Please fill out this short form and let us pray for you.  If you would like your prayer kept private - just between you, the pastor and God, please remember to check NO for the Knee Benders list, otherwise all prayer requests will be added to our Knee Benders list. This prayer list is distributed and prayed over by our congregation.

Note: Only your name, the name of the person your praying for and your prayer request will be added to the Knee Benders list. All other information will be held in the utmost confidence and will never be given away or sold for any reason.

Personal Information

Name:  

 Address:  

City:  

State:  

Zip:  

E-Mail:  

Prayer Information

This Prayer is for My << Choose One >> ____________________ Self Family Other Annonymous _____________________ Husband Wife Son Daughter _____________________ Father Mother Brother Sister _____________________ Grandfather Grandmother _____________________ Uncle Aunt Nephew Niece Cousin Other Family Member _____________________ Friend Boss Co-Worker _____________________ Nation Government Local Government _____________________ Church Pastor Church Elder

I would like to Pray for :

<< Choose One or More >> Salvation Repentance Patience Protection Enudurance Safety Healing Guidance Conviction Travel Mercies Provision Spiritual Strength Spiritual Growth Help with Drinking Help with Drugs Help with Addictions Forgiveness Marital Problems Peace Joy Happiness Love Companionship Other

Prayer Request

Please remember to keep in contact with us and let know how God has answered your prayer request!