St. Mark's Church
The following questions will help us gather some initial information about the case. Please answer every question below so we can make a complete assessment. This is the first step in their journey to salvation. Sign up so we can send your results of the application.


*First Name
*Last Name
*Email Address
1. Have you noticed dramatic changes in personality?
No Yes

2. Are there strange markings on the person's body - cuts, bruises, bites?
No Yes

3. Has there been any violent behavior?
No Yes

4. Is there a history of mental illness in the family?
No Yes

5. Is there any suspicion of drug use?
No Yes

6. Did the person have any prior interest in the occult before becoming afflicted?
No Yes

7. Is the person regularly attending church at this time?
No Yes

8. Have you noticed any strange noises in the house since the person became afflicted?
No Yes

9. Does the person complain of vivid nightmares?
No Yes

10. ... appear to be jealous of those in a better place in life?10. Does the person speak in tongues, foreign languages they cannot know or with a different tone of voice?
No Yes

Disclaimer: filling out and submitting this application absolves the Church of St. Marks and its principles of any liability in the execution of the ritual of exorcism, banishment of spirits, and removal of demonic forces. It assumes the signee is seeking spiritual help in good faith and therefore waives all right to seek legal action against the Church of St. Marks and its principles.



Thank you for filling out the application. You will receive an email response in the near future. In the meantime, take solace in the strength of Jesus Christ. God bless you.

The Church of St. Marks.