You are here

Home

Prayer Quilt Request Form

Prayer Quilts
Recipient Information :
Recipient Name:
Email:
Address:
 
City:
State:
Zip:
Phone:
Sponsor Information :
Sponsor Name:
Sponsor's relationship to recipient:
Email:
Address
 
City
State
Zip
Phone
Date of Request:

Situation/Reason for Quilt:

 

**Prayer Request for:

Please submit a photo of the recipient by mail to:

Jerusalem Baptist Church,
Prayer Quilt Ministry
3203 US Highway 601 South,
Mocksville, NC 27028. 

Or email a digital photo to:
info@jbcmocksville.org

**Please make sure that the recipient has been asked and is
ready to accept a prayer quilt, and the prayers requested are
those of the recipient.


Theme by Danetsoft and Danang Probo Sayekti inspired by Maksimer