FCM Prayer Support Request Form 
(Also available for download as a PDF)

Please check all that apply: 

 Place my name on the prayer support list for Direct Prayer.  I will also be praying for myself. 

Place the name of  (first and last) on the prayer support list for Transition Prayer. 

 Place the name of  (first and last) on the prayer support list.  This person is unable to request prayer for her/himself. 

This is an emergency request. (For emergencies, you may also phone in your request by calling 360-393-4619).  

 I would like to become a regular pray-er in the FCM Prayer Support Group.  Please contact me.

As a person requesting prayer, whether for yourself and/or another, please type your contact information below:

Name (first and last):

E-Mail address:

Telephone (with area code):