Spiritual Help Questionnaire -
This form is not mandatory and will not be kept in our records but returned to you at the end of the session. It is to help us help you with any needs you may have.

Name *
Name
Address
Address
Please fill this in if you would like a ride to our meetings
Phone
Phone
Gender
Would you like prayer today?
Have you been to a meeting like this before?
Do you have anyone to forgive?
Are you born again?