FAMILY OF THE MONTH / YEAR

For the MONTH of: *

Year: *

RECIPIENT DATA:

Recipient Name: *

Age *

Spouse Name:

Childrens' Names (if any)

Parish: *

# of years a Knight *

Council Information

Council Name: *

Council #: *

City: *

District #: *

Diocese: *

GK Name: *

Email of person submitting form *

SERVICE TO COUNCIL

List elected & appointed positions held in Knights of Columbus; committees chaired by Nominee; and nominee's family involvement in the council. *

CHURCH INVOLVMENT

Nominee's family involvement in the church includes: *

COMMUNITY INVOLVEMENT

Nominee's family involvement in the community: *

Reason (s) for choosing this family as your nominee for "Family of the Year".

Please give enough detail to inform the State Council as to why you selected this brother and his family as your council's Family of the Year. The information provided may be reprinted in publication with some alterations. *

YOU MAY SUBMIT THIS FORM ELECTRONICALY IF YOU HAVE NO ATTACHMENTS OR MAIL THE FORM WITH ATTACHMENTS TO:

ILLINOIS KNIGHTS OF COLUMBUS

P.O. BOX 681

KANKAKEE, IL. 60901-0681

If your are submitting this form electronically, please remember to print a copy before submitting form.