Community Baptist Church of Greater Milwaukee

Prayer & Notification Request Form

*Prayer Request submitted after Tuesdays, will be publish the following week.

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Name *


First Name	Last Name

Address *

Phone *

Phone Number

e-mail (optional)

Email Address

Are you a CBC Member? *

Select from list

What is your request? *

Select from list

*Requesting Prayer for another, will be listed with your name for all publication.

Addition information

Would you like for a Deacon to contact you? *

Select from list

Best time to contact you

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* required