State Family of the Month Application

State Family of the Month

Application

June - July Family of the Month – Due by July 30^th

August - September Family of the Month -- Due by September 15^th

October – November Family of the Month – Due by November 15^th

December – January Family of the Month – Due by January 15^th

February – March Family of the Month – Due By March 15^th

April – May Family of the Month – Due by May 15^th

Eligibility: Must be family of member in good standing. (Knight, Wife & Children, However if

There are no children, the Knight and wife still eligible).

Families of present State Officers, State Directors, State Chairmen, District Deputies,

Grand Knights and Former State Family of the Year ARE NOT ELIGIBLE.

First, choose one of the many worthy families in your council, use the question on back of this as a guideline to gather information, complete the application.

Second, be brief but don’t leave anything of importance out.

Be sure to enter in the Family in the Supreme Council Completion, New Haven, CT.using the form in the Supreme Council Family of the Month Booklet.

MEMBERS NAME:____________________________________________________ AGE________

Address:______________________________________________________________ Zip_________

Council Name and No.:_____________________________________________ City_____________

Proposed By:

Name:____________________________ Signature________________________________________

Address; ____________________________________________________________ Zip___________

Telephone No: (_____) ___________________ Council No.:________________________________

Send to Charles J. Kirchner

1401 White Ave

Kansas City, MO. 64126

Please Type or Print Clearly

Council Name & Number

Members Name: _________________________________ _______________________________

Members of Family: Wife___________________________________________________________

Children: (Names and Ages—Please List)

_________________________________________________________________________________

Areas of Qualification:

What has the Family done for the Church and Parish in the past two years?
What has the Family done for the Community and Council in the past two years?
What organizations is the Family Active in?
Does the Entire Family participate in and practice its Religious Beliefs?
What Hobbies, Interest or Activities does the Family Share?

Use the space below to briefly list the nominee’s qualifications. Continue on a separate sheet if necessary. Send a Family Photo if available.

_________________________________________________________________________________