KNIGHTS OF COLUMBUS ILLINOIS STATE COUNCIL

STATE DIRECTORY INFORMATION - DIR1
Use to Report Council Information

This form is for use by Grand Knights and Financial Secretaries ONLY to report their Council information and contact information for the State Directory.

READ THIS BEFORE YOU COMPLETE THIS FORM.

This information will appear in our State Directory: Please provide your COMPLETEaddress including: Directions (N, S, E, W), Avenue, Street, Drive, Lane etc.

Be sure to show your PO Box AND your HOUSE ADDRESS. The State Office needs BOTH addresses

COUNCIL INFORMATION

Council Name: *

Council #: *

Meeting Location STREET Address: *

PO Box #:

City: *

Zip Code + 4 Code (If known) *

Meeting Location Phone #:

Fax #:

Council Meets on What Days of the Month (i.e., 2nd & 4th Thurs, etc) *

Are you presently updating your council site on our website? *

Yes

No

Council Website URL Address:

Council e-mail address:

TYPE OF MEETING FACILITY: *

A] Meets at church or school hall - On meeting nights only

B] Clubroom building- rental - Open meeting nights only

C] Clubroom - K of C facility - Open to members only

D] Clubroom - K of C facility - Open to Public

E] Other E] Other

GRAND KNIGHT INFORMATION

IF THERE IS NO CHANGE IN GRAND KNIGHT INFORMATION, PLEASE CHECK BOX (You do not have to complete the GK Information if you check this box. You will need to enter phone and email so that notificates can be sent.)

No Change in Information

Name:

Membership #:

Spouse (As you want it to appear in Directory)

HOUSE Address:

Apt., Lot, Unit or Condo #:

AND PO Box #: (State office needs BOTH addresses)

City:

State

Zip Code + 4: (If Known)

Home Phone #

Business #:

Fax #:

Cell #: *

E-Mail Address: *

What contact numbers do you want to appear in the State Directory? *

FINANCIAL SECRETARY INFORMATION [As appointed by Supreme Council]

IF THERE IS NO CHANGE IN FINANCIAL SECRETARY INFORMATION, PLEASE CHECK BOX (You do not have to complete the FS Information if you check this box. You will need to enter phone and email so that notificates can be sent.)

No Change in Information

Name:

Membership #:

Spouse (Print clearly as you want it to appear in Directory)

HOUSE Address:

Apt., Lot, Unit or Condo #:

AND PO Box #: (State office needs BOTH addresses)

City:

State

Zip Code + 4: (If Known)

Home Phone #

Business #:

Fax #:

Cell #: *

E-Mail Address: *

What contact numbers do you want to appear in the State Directory? *

If you are mailing this form, please return it to:

Illinois State Council

PO Box 681

Kankakee, IL 60901-0681

A copy of this form will be sent to the email addresses supplied for GK and FS