Village Church - Destin Florida - LOVE GOD. BE REAL. BRING HOPE.

village baptist church

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Prayer Request Form

Please complete the form below with as much information as possible. Fields marked with an asterisk (*) are required.

Person Needing Prayer

* Prayer Request Type:
* First Name:
* Last Name:
Address:
City:
State:
Zip Code:
Phone:
Email:
* Is this person a member of Village Church?:		Yes No
Life Group Class (if applicable)
Prayer Request:
Is this prayer request confidential?		Yes No


Person Making Request

* First Name:
* Last Name:
Phone:
Email:
Are you a member of Village Church?		Yes No


Hospitalization

Hospital Name & Location


Sympathy

Name of Deceased:
Surviving Spouse Name (if applicable):
Funeral/Memorial Service Details (include date, time, address):
Requester's Relationship to Deceased:

Village Baptist Church
101 Matthew Blvd. Destin, FL 32541
850.837.8107

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