Personal Prayer Ministry

Changing the world
one person at a time…

Confidential Application For Personal Prayer Ministry


Confidential Stamp Image

Thank you for your inquiry! This form will take around 15 - 20 minutes to complete. It will help us to get a better picture of your life situation so that we can better minister to you. Information is kept private.

Please note that fields with an "
x" must be filled in. The other fields help us to identify problem areas more quickly but are optional. We only need significant highlights and patterns, not your whole life history.

PERSONAL INFORMATION
Click "Reset" to clear all fields if desired...
Only 7 p.m. is available on Mondays. Only 10 a.m. is available on Fridays.


FAMILY BACKGROUND


ANY SIGNIFICANT PAST EVENTS
Thank you for taking the time to complete the application.

Our desire is to be as warm and personal as possible. However, those in helping professions need to satisfy the legal requirements of informed consent.

By submitting your application, you are acknowledging that you have read and accept the
legal waivers at this link. (This will open in a new window, which you can close when finished, before clicking the "Submit" button below.)