Testimony Form

First Name

Last Name

Phone/Mobile

Are you a regular member of any Church or Ministry currently?

FOLJ Church

Other Church / Ministry

Not part of any Church

Other Ministry Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Details of the problem

Text Input

Do you have a medical report from before the healing took place?

Yes

Upload report from before the healing:

Choose File

Efforts

What happened

Do you have a medical report after the healing took place?

Yes

Upload report from before the healing:

Choose File

Current status

Would you like to upload a testimony video?

Choose File

Faith comes by hearing