Prayer Request Form

Please use the following form to send a prayer request. I greatly appreciate you completing all the items on the form; this allows me the opportunity to clarify your request, ask for an update (which I try to do periodically) or, in the rarest of cases, advise you of why I am unable to post your prayer request.

In the recent past, Geocities' form serving script has been having problems. In the event that this form is not processed properly, please send me an e-mail message with your prayer request. Your friend, Ken

Information about you:

Your Name (first only, please) :
Your E-mail address:

Prayer Request

This Prayer Request is for:
NOTE: THIS IS A REQUIRED FIELD. When I update the prayer request listing, I will only use the initials of the person(s) being prayed for.

Type of Prayer Request: (Select from below)
Salvation
Healing
Guidance/Direction
Praise Report (for answered prayer)
Other

Brief details (OPTIONAL: God already knows and will honor your request)

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