Submit Prayer Request

Your details are strictly confidential and will never be revealed without your prior consent.
In the tradition of King Solomon, all prayers will be addressed to God only and not to any particular name of God.

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Gender:
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First name of person being prayed for:
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Last name of person being prayed for:
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Gender of the person being prayed for:
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What is your prayer request?
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(Maximum characters: 400)    You have 400 characters left.
Details about the person prayed for:
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Prayer Options: (Tax-Deductible)
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Description of Prayers
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$
Tell us what best describes you:
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Form of payment:
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Credit Card (Secure Service). *Prayers generally start within a week.

Check will be mailed. *Prayers generally start approx 3 weeks from the date of mailing from the US or Canada (see address below). Please note the name that was used for signup (if different than the name on the check).

Name on the Card:
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Type of Credit Card:
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Credit Card Number:
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Credit Card Expiration Month:
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Credit Card Expiration Year:
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Last 3 digits on the back of the Card:
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Last 4 if your Card is American Express:
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How did you find out about us?
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Other:

When is your birthday? (yyyy-mm-dd) :
Do you want to receive 40 day short prayer reminder inspirational emails?: Yes    No
Terms and Conditions
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Wailing Wall Prayers reserves the right to adjust and/or refuse certain prayers based on moral grounds. In a case where prayers are refused, a full refund will be made.
I AGREE

Checks to be mailed in AmericaChecks to be mailed in Israel
Should be made out to:Should be made out to:
American Friends of Kollel Tefillat MosheAmerican Friends of Kollel Tefillat Moshe
and mailed to:and mailed to:
American Friends of Kollel Tefillat Moshe
116 South 4th Avenue Highland Park
NJ
08904-2623
American Friends of Kollel Tefillat Moshe
C/O Shira Piha
56/14 Nachal Dolev
Beit Shemesh 99621
Israel

When your form is submitted, you will receive a confirmation email. If you do not receive this confirmation, please contact info@wailingwallprayer.org. Thank you!

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