Application to become a Chapter

To join, fill out and submit the application below. (This information will be be used by Prayers & Squares for membership purposes only.) After you submit this application, you will be taken to PayPal's SECURE site where you can use your credit card to pay the $50 membership fee.
We would like to become members as an official chapter of Prayers & Squares, The Prayer Quilt Ministry. We agree to follow the "Three Commandments of Prayers & Squares".
Organization/Church *indicates required entry
*Mailing Address:
Church Website (if applicable):
In order to reduce expenses and to ensure you are updated in a timely manner, we use e-mail to keep in touch with our members. Please designate a contact person who has internet access, and can receive and print out e-mail. This person accepts the responsibility of relaying P&S communications to the chapter leader and/or other members.
Contact Person
*First Name:
Privacy Note: Contact and Leader telephone numbers, email and mailing addresses are NOT listed or shared on our website; they are for Prayers & Squares internal use only.
*Last Name:
*Mailing Address:
*Enter round fruit that starts with "a"
 Helps minimize spamming
Group Leader (if different)
We like to know who you are.  Please use the "Comments" box below to tell us a little bit about your church or group. Also, how did you hear about the ministry, and what kind of help or support would you like to get from the Prayers & Squares organization? Thank you!

Please read over your appication information above and click "submit"
ONLY ONCE, or we will receive multiple applications from you.
The next page will take you to PayPal's secure site. You DO NOT need to log in to PayPal and enter a password. You can choose to pay with your debit or credit card, or with PayPal's Bill Me Later® service.