A congregation of the Evangelical Lutheran Church in America

Prayer Request Form
(To remove a prayer request from our prayer list....click here.)



Your Name (person requesting prayer):
Your Contact Information - Phone:
Email (optional):
Relationship to the person (optional):
Name of Person(s) (prayer request for):
Request Date
How long would you like the prayer concern to be on the list?:

           Weeks:       1     2    3

           Months:      1      2    3    4     5    6

Note: Please contact the church office at 847.367.4060 or at if you would like to extend the prayer concern beyond 6 months.

Reason: (optional):


Please include this prayer request in the following communications (check all that apply):

            Bulletin

            Website

            Pastoral follow-up


If you have any questions or comments, please contact the church office at 847.367.4060 or via email at .

All prayer requests will remain confidential.


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