Prayer redemption-org

Prayer register

Jesus

Card number?*

Name?*

Email?*

Create password for credential protection*

Gender?*

Age?*

Nationality?*

Place of residence?*

Profession?*

Phone number?*

Next of kin name and his/her phone number?*

Have you been on prayer line before if "yes", when?*

Please state the nature of problem(s)*

How long have you experienced this/these problem (s)?*

How has this affected your career, marriage, finances, business etc.?*

What kind of dreams do you experience?*

Have you ever been initiated into a any cult, secret society or anything that could be potential cause to the problem you are facing? Yes/No, If "Yes" please provide details*

Please write other prayer request in the box below*