Member Fraternal Survey

KofCFormLogo  Council 2179 Annual Fraternal Survey
 Individual Member Worksheet

Over the last ten years, the Knights of Columbus donated more than $1.5 billion to charitable and benevolent causes and more than 682 million hours of volunteer community service to aid the less fortunate. To help prepare our Fraternal Survey for the Supreme Council office, please complete the information requested below and return it at our next meeting. This information will assist us in determining the total number of hours of community service volunteered by our members.

Fraternal Year:

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Member's Name: Invalid Input

1. Number of visits you made during the year to:
Sick — caring for the sick / nursing homes / hospitals (*)  Invalid Input
Bereaved — visits of condolence (*)  Invalid Input
2. Number of times you served as a blood donor during the year (*)   Invalid Input
3. Estimated hours of community volunteer service during the year:
Church Activities — service in all Church related activities (*)   Invalid Input
Community Activities — service in all community related activities (*)   Invalid Input
Youth Activities — service in all youth related activities (*)   Invalid Input
Habitat for Humanity — service in all related projects (*)   Invalid Input
Culture of Life Activities — service in all related projects (*)  Invalid Input
VAVS (*)   Invalid Input
Food For Families (*)  Invalid Input
Special Olympics (*)   Invalid Input
Miscellaneous Activities — service in areas not outlined above (*)  Invalid Input
4. Number of hours of fraternal service during the year:
Sick/disabled members and their families — household chores, transportation, tutoring, counselling, etc. (*)   Invalid Input

Capatcha:

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