Please fill out the form below or give us a call at (717) 945-3081.Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Email* Phone*Best time to contact you?Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Are you a member of Threshold Church?* Yes NoIf not, how long have you been attending?How did you hear about Threshold Church?*Describe your testimony and relationship with God.*Describe why you are seeking deliverance ministry. What areas are you needing freedom in?*How long have you been experiencing this?*Have you ever received counseling or ministry for this in the past? If so, when and what was your experience?*Are you aware of anything that may have given access to demonic influence in your life? If so, briefly explain:*Terms* By checking this box I understand that any private prayer ministry sessions are in-person only and based out of Lancaster, PA. I understand and agree that personal prayer ministry received through Threshold Church is not Licensed or Professional Counseling and does not take the place of Licensed or Professional Counseling Services.*Subscribe Subscribe to the Monthly Deliverance Newsletter!NameThis field is for validation purposes and should be left unchanged.