Request 5 Word Prayers for Inmates

Please fill out the information below to request books for your prison ministry.

Name*
First Last
Email*
Phone*
How many books are you requesting?*
Requested Date for Books*
For male or female inmates?*
- Female
- Male
- Both
Shipping Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Jailer Name & Contact Info*
How often do you do ministry there?*
What is your role in ministry there?*
What is your relationship with the admin/jailer?*
Will you be in charge of dispersing books to the inmates?*
- Yes
- No
Is this affiliated with a church/other ministry?*
- Yes
- No
If YES, what church/ministry?
Is there anything that will hinder you getting books to inmates?*
- No
- Yes
One reference to call (Name + Phone)*