IMPORTANT: Upon pressing [Submit Prayer Request], you should see an acknowledgement indicating that your request has been received. If you do not see that, re-check this page for red text to the right of each line indicating that a field is missing or needs additional information. If you do not see the message that your prayer request was received, it has not been submitted.
Who is this prayer
requested for?

(First Name)

(Last Name)
Details of Prayer Request

(Please limit to 250 characters. You can provide more information when we contact you.)
Their Contact Phone Number
(999) 999-9999 x-9999
Their Location
(City/State, Hospital/Room Number)
Are they a member of a church?  Yes, Johns Creek United Methodist Church
 Yes, other: 
(Please enter church name)
Would you like for your prayer concern to be listed in the Sunday Order of Worship?
(Concerns will be listed in the Sunday Order of Worship for four weeks. However, concerns will stay on the church-wide prayer list for as long as needed.)
Would you like a prayer note mailed to them?  Yes (if checked)
(If checked, please provide us with their mailing address:)

I would like to be referred to a Stephen Minister  Yes (if checked)
Your name
(First Name)

(Last Name)
Your relation to the person being prayed for
Your email address
(If you have one, we will email an acknowledgement to you for this prayer request only.
 We will not send unsolicited email and will not share your email address with anyone else.)
Other Contact Information
(Provide your telephone number or address if you prefer that we contact you that way.)

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