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    Prayer Request Form

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    Person making request (full name)
    Phone of requestor (required for most options below)
    Email of requestor
    Name of person being prayed for (full name, if self just indicate "self")
    Phone of person being prayed for (optional, but recommended)
    Is it okay to contact the person being prayed for?
    Check one of the following options
    Prayer request
    To proclaim and embody the love of Jesus Christ in the city and in the world.

    5385 N Green Bay Ave. | Milwaukee, WI 53209
    414.228.5220 | (f) 414.228.5235
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