Request A Quilt

Request a Quilt

* Indicates required field

Name of Recipient *

First

Last

Requested By *

Relationship to Recipient *

Reason for Request *

Requestor's Email Address *

Requestor's Phone Number *

Date Needed *

COMMENTS *

Your personal/contact information is solely for our Prayer Quilt team and will never be shared with anyone else. The name of the Recipient and the Prayer Request will be the only information shared with the congregation so they can be praying daily. If you wish to have the name withheld, please make a note in the comment box. Thank you!

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