Ministry Request Form
THIS FORM IS ONLY A FIRST STEP.

We will contact you after receiving your request for ministry to discuss your request and, if it seems like the right step, to set up a prayer appointment.

Your information is kept confidential, stored in a drive folder that is accessed only by a small and trustworthy team of prayer ministry coordinators. We do not share your form with your prayer leader in advance of your appointment.

IF YOU WANT TO TALK TO SOMEONE IN PERSON ABOUT THIS FORM, YOU CAN CALL 734.660.6268.
Email *
Are you over 18? *
Today's date *
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How did you hear about contacting us for prayer ministry? Check all that apply. *
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First name *
Last name *
Gender *
Age
Preferred Phone Number *
Alternate phone number (optional)
Street Address
City/Town of residence *
State *
Postal code *
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