New Year's Day, January 1 - Pentecost, May 31, 2009

If possible, please submit this form by Nov. 30, 2008, however, registrations are welcome throughout the course of the Chain of Prayer. (See what days have already been chosen (link to become available). This opens in a new window.)

Name of Meeting Yearly Meeting

Contact person for the CHAIN OF PRAYER:
Name:
Address:
City: State/Province Postal Code:
Country (if other than USA)

Home Phone: - Work Phone: -
Email address, if available

3. Over the course of the Chain of Prayer, we would like to participate:
one time two times three times

4. We understand that you are trying to have a continuous chain of prayer:
Please assign our day(s) for us.
We prefer Sunday Monday Tuesday Wednesday Thursday Friday Saturday but we will accept any day assigned.
Please try to accommodate our preference for the dates requested. You will call or email us if there is a conflict over dates.
First Choice:
Second Choice:

5. We would like to contribute $ for the packet of materials.
Please bill us.
We will use the on-line contribution page to make our donation (please be sure to indicate this purpose in the "comments" section).

6. Description and Prayer Concerns from our Meeting:
(a) our setting is rural; small town; suburban; city
(b) our average worship attendance is
(c) our worship is unprogrammed; follows an order of worship.
(d) Prayer requests (you could include both what you are rejoicing over and your needs):

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