Life Room Prayer Partner Application

Contact Information

Thank you for your desire to join a prayer time live prayer room! This form is a quick formality to help us get to know you.

Once your form is reviewed, our team will be in touch with you to give instructions on how to join at the time of your preference.

First Name *

Last Name *

Street Address *

City *

Province / Territory *

Postal Code *

Phone Number *

Email Address *

Preference

Please let us know what prayer time(s) you would like to join. You can choose more than one if you like. Please be sure to write in eastern time, or if that is too confusing, write in your own time zone but let us know what your time zone is: *

Getting To Know You

In a couple sentences, please tell us a bit about yourself and why you would like to participate in the Life Room: *

Which church do you attend regularly? *

What is your pastor's name? *

Please share, briefly, how you are involved in the life of your church (aka: attend on Sunday, attend Bible study, lead a prayer time, help with kids church....): *

References

Please provide TWO references (names and phone numbers) of a pastor or ministry leader who can speak to your spiritual maturity. If someone who is already a part of the Life Room recommended you get involved, just let us know who they are. Thank you so much!:

Reference 1: *

Reference 2: *

Thank you! One of our team will be in touch with you soon.