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Address *

Age *

Please chose 3 or more most difficult ones from your above list and further describe the problem in a paragraph or two to give a better picture of situation. *

Please tick any of the challenges below (as many as relates to you) that you'd like us to stand in the gap praying with you. *

Unemployment

Financial hardship

Conflict in marriage

Divorce

Singleness

Bareness

Discouragement

Constant fear

Illness

Failures

Nightmares

Regression

Family history

Death

Debt

Defilement

Dysfunction

Dejection

Depression

Drugs

Divination

Forgetfulness

Anger

Alcoholism

Child problems

Growing up challenges

Other (Please note it below)

Country of birth *

Sex *

Male

Female

Marital Status *

Single

Single (Mum or Dad)

Married

Divorce

Separated

Other

pastor's prayer line

we encourage you to complete the form BELOW:

This form will enable the leadership to get to know you better as well as equip them to pray more effectively for you and your family. Your information are keep in confidence and it is for prayer and administrative purpose only.

Phone *

Email: *

Name: *

Thank you for completing the prayer survey, be rest assured that we are praying for you and your family. The leadership may contact you if they require any further information. You can also contact the leadership if need be on 07852216366.

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pastor's prayer line

we encourage you to complete the form BELOW:

​​​​​​Privacy policy | Safeguarding | Risk Assessment | Child Protection Policy

Privacy policy | Safeguarding | Risk Assessment | Child Protection Policy