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* What can we pray with or praise with you about?
Please do not put your full name. If you wish for this to be identified as your own, you may put your initials only.

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* Is this a new prayer request or an answered prayer?

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* By filling out this survey you are agreeing to allow your prayer or praise to be posted on Quill's prayer wall (listed as "The Prayer Wall"). Your name will not be posted, merely you initials if provided.

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