Practitioner Listing Form

List your healing practice on
PrayerfulHelp.com

Annual fee: $69 for main listing
(additional geographical cross reference listings $25/each/year)
(additional cross reference for high school and college-aged Christian Scientists $25/year)

No charge for changes to listing during the year.

Questions?
eMail us or call 602-635-1987

Use this online form to place your listing as a full time or part time Christian Science Practitioner. We welcome Practitioners listed in the Christian Science Journal as well as those who are not. Your listing will appear on PrayerfulHelp.com. Once you have completed the form, you will be taken to a page where you may pay the listing fee online by credit card or you will be given the mailing address to pay by check or pay by telephone 602-635-1987.

All listings must be prepaid before they will be set up and activated. [You will be taken to a payment page once this form is completed. Payment may be made by check or you may make a credit card payment thru our secure online PAYPAL processing link.]

Contact Information (for our use):

First and Last Name**

eMail Address**

Re-enter eMail Address**

Submitter phone number with area code**

Submitter mailing address (for billing only)**

Have you had Christian Science Primary Class Instruction? **
(for office use only)
Yes, I have had Christian Science Primary Class Instruction
No, I have NOT had Christian Science Primary Class Instruction
If YES, who was your Christian Science Teacher?
(for office use only)

Special instructions/questions

Information which will appear in your listing:

How do you want your name to appear in the ad?**

Please choose one:**
CS      CSB

Are you a member of The Mother Church?**
yes no
TMC membership is not required, but will be indicated

PrayerfulHelp.com is an independent web site. We accept listings of Christian Science Practitioners who are full time Journal-listed as well as non-Journal-listed full and part time Practitioners. People working toward their Journal-listing may also wish to use this advertising opportunity to help them in establishing their practice. Please chose your classification below. They will appear in your practitioner listing**
Full time, Journal-listed practitioner (JL-FT)
Full time, not listed in the Journal (FT)
Part time, not listed in the Journal (PT)

CONTACT INFORMATION:

Address listed in ad (optional)

City/State/Country including postal code**

Telephone Number (including area code)

Mobile Phone Number (including area code)
(optional)

Fax number optional (including area code)
(optional)

eMail address (HIGHLY RECOMMENDED)

Text messaging (optional - no extra charge)

Instant messaging (optional - no extra charge)

Skype ID (optional - no extra charge)
[what is Skype?] Skype:

WEB SITE INFORMATION (no extra charge):

Web site - Do you have a personal web site for your practice? We're happy to list it. (optional - no extra charge)

Blog site - Do you have a personal blog site (what is a blog?) for your practice? We're happy to list it. (optional - no extra charge)

SOCIAL MEDIA INFORMATION (no extra charge):

Facebook (optional - no extra charge) how does your name appear on Facebook?

Twitter - (optional - no extra charge) what is your Twitter username?

Linked-In - (optional - no extra charge) how does your name appear on Linked-in?

OTHER (no extra charge):

LGBT friendly (optional - no extra charge)
Yes, include this designation. LGBT friendly = willing to work with members of the LGBT community in a non-judgmental, loving way, regardless of one's sexual orientation.

Introductory message (optional - no extra charge) - You are allowed a 150 character (letters and spaces) introduction printed with your listing. Use this to list your office hours, a statement of hope and healing, a quotation, etc.

Links to articles you have published in the Christian Science Journal and/or Sentinel (optional - no extra charge)
I have had article(s) published in the Christian Science Journal and/or Sentinel and I would like to include a link to them in my practitioner listing on PrayerfulHelp.com. By me ticking this box and including the article(s) Title and reference information I (as author) am giving Prayerful Living to include a shared link from JSH-Online to my article(s).

Journal/Sentinel article(s) reference (optional - no extra charge) - Please list all of your articles that you would like us to include a link to.
ex: "God is Love" Journal, January 2013
ex: "Feed My Sheep" Sentinel, April 4, 2001

Photo (optional - no extra charge)
(expample on right) you may eMail us a photo (after you have completed this form) for your listing. The photo will be displayed at least 137 pixels wide x 200 pixels high. (We can size it for you here.) If you need to mail us a photo, send it to Prayerful Living Publishing, PO Box 6871. Goodyear, AZ 85338 USA

Yes, I will be eMailing/mailing a photo for inclusion in my listing.

LANGUAGE CROSS REFERENCE LISTING:
(optional - no extra charge)
Do you speak a language other than English? We would love to include you in our "Practitioners who speak languages other than English" cross reference. It is FREE. Simply list the other languages you speak in the box below.

OTHER (fee-based):

GEOGRAPHICAL CROSS REFERENCE LISTINGS:
You may be listed under another city/state or country if you wish. Cross reference listings are an additional $25/year each. Please indicate the city/state/country you wish to cross reference your listing.
Cross reference 1
Cross reference 2

Additional geographical cross references? contact us

High School and College Student CROSS REFERENCE LISTING:
I would like to be listed on cross reference for high school and college-aged people. Listing here indicates your readiness to help high school and college-aged people. This cross reference costs $25/year.

Thanks so much. Please allow up to 72 hours for your listing to be set up.
** required fields