Date:

Please pray for (name):
Does he/she attend Kingdom Harvest COGIC?
IMPORTANT
Do you desire this person to be contacted by Kingdom Harvest?



If yes, it is necessary for us to have the following information... 



Name:
Address:
City, State, ZIP:
Telephone Number :
Best time to contact:
YOUR INFORMATION
Name:
Address:
City,State,ZIP:
Telephone Number:
Email: