d54 rfIf you have a general prayer request, please complete this questionaire.

Based on your responses, someone from our Prayer Team will contact you within 48 hours.

Your First Name

Your Last Name

Your Phone Number

Your Email

Are you a member of Central United Methodist Church?

For whom would you like for us to pray?
 Me My Family member My Friend My Co-worker My Neighbor(s) Other

What are the first names of the persons for whom we are praying?

Which categories best describe your prayer request? (required) (for multiple selections, hold down the CTRL key)

Your Message

Would you like for a Prayer team member to contact regarding your request? (required)

What is the best way to contact you? (required) (Hold down the CTRL key for multiple selections)

If contacting by phone, what is the best day and time to contact you?

Please type the security code in the space provided (required)