Prayer Request

If you would like us to join you in prayer over a particular concern in your life or the life of a loved one, please fill out the form below.

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Name *
E-mail Address *
Prayer Request
This Prayer Request may be shared with the: *
If You Are Asking for Prayer For an Upcoming Medical Proceedure, Where Will it Take Place? (Name and Location of Hospital)
On What Date is This Proceedure Taking Place?
At What Time is The Proceedure Taking Place?
Would You Like to Have Someone From The Church Contact You Before the Proceedure to Pray With You?
If a Pastor is Available Would You Like to Have a Pastor Present With You or Your Family at The Time of The Proceedure?
I prefer to be contacted by
I can be Reached at This Phone Number.

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58 Drakesdale Rd, Flanders, NJ 07836
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