KNIGHT 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: *

Reason (s) this Brother was chosen as "Knight of the Month"

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

Email of Person Submitting this Form: *

In May, a committee will select an Illinois Knight of the Year from the 12 knights chosen as Knight of the Month. Thus, it is important that you provide as much information as possible about your council's selection. If one of your applications is selected as Knight of the Year you may be asked to submit additional information (photo. etc).

YOU MAY SUBMIT THIS FORM ELECTRONICALY OR MAIL THE FORM TO:

ILLINOIS KNIGHTS OF COLUMBUS

P.O. BOX 681

KANKAKEE, IL. 60901-0681

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