401OFFICERS REPORT by Knights of Columbus

CIRCLE OFFICERS AND CHAIRMEN FOR THE TERM JULY 1, 20___ TO JUNE 30, 20___ Circle #

Co/Asm #

DUE BY: AUGUST 1

PLEASE PRINT – INDICATE MEMBERSHIP NUMBERS MEETING LOCATION ADDRESS

DATE OF ELECTION ADDITIONAL ADDRESS

Detach and mail to: Knights of Columbus Supreme Council Office, Department of Membership Records 1 Columbus Plaza, New Haven, CT 06510-3326 or Fax to: (203) 752-4113

STREET CITY

MEMBERSHIP NO.

CHIEF SQUIRE

POSTAL CODE

LAST NAME

FIRST NAME

TELEPHONE NUMBER

INITIAL

E-MAIL ADDRESS

ADDRESS MEMBERSHIP NO.

FATHER PRIOR TELEPHONE NUMBERS:

LAST NAME

RESIDENCE

FIRST NAME

INITIAL

E-MAIL ADDRESS

BUSINESS

ADDRESS

MEMBERSHIP NO.

DEPUTY CHIEF SQUIRE

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

E-MAIL ADDRESS

MEMBERSHIP NO.

NOTARY

E-MAIL ADDRESS

MEMBERSHIP NO.

BURSAR

E-MAIL ADDRESS

MEMBERSHIP NO.

SPIRITUAL CHAIRMAN

E-MAIL ADDRESS

MEMBERSHIP NO.

SERVICE CHAIRMAN

E-MAIL ADDRESS

MEMBERSHIP NO.

CIRCLE CHAIRMAN

E-MAIL ADDRESS

MEMBERSHIP NO.

MEMBERSHIP CHAIRMAN

E-MAIL ADDRESS

OUR CIRCLE... HAS ITS OWN CEREMONIAL TEAM IS FORM 468 – 1/07

❏

COUNCIL

❏

CHURCH

❏ YES ❏ ❏ SCHOOL

MEETS DAY

TIME

❏

MILITARY-BASED 1

CIRCLE COUNSELORS List below the Knights who have been appointed to the positions of chief counselor and counselor in the Squires circle. Each Knight who has been appointed to the position of chief counselor or counselor must have a current, approved Youth Leader application (Form #4348) on file at the Supreme Council office. If he does not, he must complete a Youth Leader Application Form (#4348) and submit it to the grand knight/faithful navigator. Priests serving as father prior are exempt from submitting Form #4348. Priests are also exempt if they are serving as chief counselor or as a counselor, and their status as a priest should be indicated by checking the “Priest” box next to their entry. YOUTH LEADER FORM #4348

CHIEF COUNSELOR

(Check One) SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. TELEPHONE NUMBERS:

LAST NAME RESIDENCE

FIRST NAME BUSINESS

INITIAL FAX

ADDRESS E-MAIL ADDRESS

YOUTH LEADER FORM #4348

COUNSELORS

(Check One) SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO.

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

SIGNED NOTARY

FORWARD TO: Knights of Columbus Department of Membership Records 1 Columbus Plaza New Haven, CT 06510–3326 2

DATE

CHIEF COUNSELOR

COPIES TO: State Squires Chairman, Grand Knight, Circle File

DATE

Once completed by applicant, give the original to the grand knight/faithful navigator. After the grand knight or faithful navigator or his designee checks the references listed and is satisfied the candidate is suitable for appointment, he should sign the form and forward it to the state deputy for his signature and subsequent forwarding to the Supreme Advocate’s office.

YOUTH LEADER APPLICATION PLEASE TYPE OR PRINT IN CAPITAL LETTERS

(State / Province)

❏ Squires Advancement Counselor

RESIDENCE TELEPHONE #

BUSINESS TELEPHONE #

Current Address:

FAX

SOCIAL SECURITY # / TAX ID #

City

State/Province Zip/Postal Code Dates

City

State/Province Zip/Postal Code Dates

Previous street addresses since 18th birthday:*

Current Employer: Previous Employers (last 5 years):

High Schools attended:

City, State/Province of residence while attending

Colleges/Universities/Graduate Schools attended:

City, State/Province of residence while attending

*use additional sheet if necessary 4348-NC 1/07

Military Experience:

City/State/Country of duty residence

Dates

Note: The “Social Security #,” “Date of Birth,” complete residence addresses, and locations of employers and schools must be provided, and the applicant must sign the form, or the form will be returned.

Important processing instructions: Once completed, the applicant should give the form to the grand knight or faithful navigator. After the grand knight or faithful navigator, or his designee, checks the references listed and is satisfied the candidate is suitable for appointment, he should sign the form and forward it to the state deputy for his signature and subsequent forwarding to the Office of the Supreme Advocate. Upon approval of the supreme advocate, a certificate will be sent to the applicant confirming his appointment. Approval is good for up to three years from the date on the certificate.

ANNUAL SURVEY OF FRATERNAL ACTIVITY

Duplicate and distribute this form to circle members for completion during a November meeting. Collect the forms during the meeting. Use the information provided when preparing your circle’s Annual Survey of Fraternal Activity.

INDIVIDUAL MEMBER WORKSHEET INSTRUCTIONS TO FINANCIAL SECRETARIES / FAITHFUL COMPTROLLERS / BURSARS Located on the lower portion of this page are individual Member Worksheets to assist you in determining the number of hours of volunteer service expended by members during the calendar year. This worksheet is printed on clip-art ready, reproducible paper. Simply photocopy as many forms as you need, cut along the dotted line and distribute forms at the November meeting. Forward a worksheet to every member on your current roster or include a copy in your next bulletin. Each member can individually identify the number of volunteer hours he expended in community service projects. You only need to collect and tabulate the council/ assembly/ circle results for completion of the Annual Survey of Fraternal Activity Report due at the Supreme Council office by January 31. .......................................................................................................................................

ANNUAL SURVEY OF FRATERNAL ACTIVITY INDIVIDUAL MEMBER WORKSHEET In one recent year, the Knights of Columbus donated more than $139.7 million to charitable and benevolent causes and more than 64 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 during the calendar year. 1. Number of visits you made to: Sick — caring for the sick / n ursing homes / hospitals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

Bereaved — visits of condolence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

2. Number of times you served as a blood donor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

3. Estimated hours of community volunteer service: Church Activities — service in all Church related activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

Community Activities — service in all community related activities . . . . . . . . . . . . . . . . . . . . . . .

______________

Youth Activities — service in all youth related activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

Habitat for Humanity — service in all related projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

Miscellaneous Activities — service in areas not outlined above . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

4. Number of hours of fraternal service: Sick/disabled members and their families — household chores, transportation, tutoring, counseling, etc._____________ .......................................................................................................................................

______________

Bereaved — visits of condolence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

2. Number of times you served as a blood donor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

3. Estimated hours of community volunteer service: Church Activities — service in all Church related activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

Community Activities — service in all community related activities . . . . . . . . . . . . . . . . . . . . . . .

______________

Youth Activities — service in all youth related activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

Habitat for Humanity — service in all related projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

Miscellaneous Activities — service in areas not outlined above . . . . . . . . . . . . . . . . . . . . . . . . . . . .

______________

4. Number of hours of fraternal service during: Sick/disabled members and their families — household chores, transportation, tutoring, counseling, etc._____________ 1728A 1/07

ANNUAL SURVEY OF FRATERNAL ACTIVITY INSTRUCTIONS For Twelve Month Period Ending December 31, 20___ Due By: Please type or print legibly. JANUARY 31 , ,1 0 0 Complete numerical data from right to left – ex. In sections II and III use EXACT DOLLAR AMOUNTS. UNITS IN THE PHILIPPINES SHOULD REPORT ALL FINANCIAL DATA IN PESOS. Include financial contributions and hours of community service from all related programs. Do not write-in additional activities or contributions – use only spaces provided. MAKE A PHOTOCOPY OF SURVEY REPORT FOR YOUR CIRCLE FILE.

Detach and mail to: Knights of Columbus Supreme Council Office, Department of Fraternal Services 1 Columbus Plaza, New Haven, CT 06510-3326 or Fax to: (203) 752-4108

*IMPORTANT * * * * * * *

SECTION I. NUMBERS OF MEETINGS HELD DURING YEAR: 1. Regular – meetings for conducting or discussing business. Include officers and Service program committee meetings. 2. Social – dinners, sports, dances, etc. Business may or may not have been discussed. 3. Special – lectures, films, seminars, cultural, ethnic, educational, religious events, etc. Business may or may not have been discussed. SECTION II. ACTIVITY EXPENSE: 1. a. Printing and Postage – printing and postage for newsletters, flyers, communications for circle activities. b. Food and Refreshments – food, refreshments, etc. for circle activities. c. Prizes – gifts, awards, incentives, raffles, etc. related to circle sponsored events. d. Projects – transportation, facility rental, photography, etc. for circle related projects. e. Entertainment – bands, magicians, comedians, etc. for circle events. f. Miscellaneous – all other expenses not outlined above relating to circle activities.

SECTION III. CHARITABLE AND BENEVOLENT DISBURSEMENTS:

Church Activities 1. a. Church Facilities – construction, repairs, remodeling, memorial gifts, etc. b. Catholic Schools – donations, grants, construction, repairs, etc. c. Religious Education – CCD, lay apostolate, Keep Christ in Christmas, marriage encounter, etc. d. Seminarians/RSVP – direct contributions to seminarians, postulants and religious. e. Seminaries – donations, construction, equipment, etc. f. Vocations Projects – programs, speakers, films, program materials, etc. g. Miscellaneous – all other Church related disbursements not outlined above.

Community Activities 2. a. Elderly – homes for the aged, Retired Senior Volunteer Program, etc. b. Physically Disabled – Muscular Dystrophy, Cerebral Palsy, etc. c. Special Olympics – local, state and national contributions, etc. d. Citizens with Intellectual Disabilities – candy distributions, etc. e. Human Needs – caring for the sick, food, clothing, shelters, soup kitchens, homeless, etc. f. Pro-Life Programs – printing, donations, hall usage, Birthright, baby showers, etc. g. Victims of Disasters – natural disasters, fire, violence, accidents, etc. h. Hospitals/Institutions – equipment, construction, memorial gifts, etc, i. Health and Service Organizations – Red Cross, Hospice, cancer/heart funds, etc. j. Community wide Projects – civic involvement, public safety, environment, decency, etc. k. Habitat for Humanity l. Miscellaneous – all other community related disbursements not outlined above.

Youth Activities 3. a. Columbian Squires – overall sponsorship, contributions, etc. b. Scouting – sponsorship, contributions, etc. c. Youth Groups – CYO, Big Brothers/Big Sisters, 4-H, etc. d. Youth Welfare/Services – substance/child abuse, foster parents, etc. e. Athletics – equipment, league/team sponsorship, transportation, etc. f. Scholarships/Education – career nights, essay contests, tuition, fund raising, etc. g. Miscellaneous – all other youth related disbursements not outlined above.

SECTION IV. FRATERNAL COMMITMENT:

Number of visits to: 1. a. Sick – caring for the sick/nursing homes/hospitals. b. Bereaved – visits of condolence. 2. Number of blood donors – members serving as blood donors. 3. Habitat for Humanity projects – number of projects involved in during the year.

Estimated hours of community volunteer service: 4. a. Church Activities – volunteer service in all Church related activities. b. Community Activities – volunteer service in all community related activities. c. Youth Activities – volunteer service in all youth related activities. d. Habitat for Humanity – services to these projects. e. Miscellaneous Activities – volunteer service in any areas not outlined above.

Estimated hours of fraternal service: 1728C 1/07

5. Sick/disabled members and their families – household chores, transportation, tutoring, counselling, etc.

ANNUAL SURVEY OF FRATERNAL ACTIVITY FOR TWELVE MONTH PERIOD ENDING DECEMBER 31, 20___

S Circle Number ___________________ Location ____________________________________ city/town

Youth Activities

1. Regular 2. Social 3. Special

TOTAL NUMBER OF MEETINGS HELD II. ACTIVITY EXPENSE 1. a. Printing and Postage b. Food and Refreshments c. Prizes d. Projects e. Entertainment f. Miscellaneous

TOTAL ACTIVITY EXPENSES

DOLLARS ONLY:

, , , , , ,

III. CHARITABLE DISBURSEMENTS: Church Activities 1. a. Church Facilities b. Catholic Schools c. Religious Education d. Seminarians/RSVP e. Seminaries f. Vocations Projects g. Miscellaneous

Total Church Disbursements

DOLLARS ONLY:

, , , , , , ,

Community Activities 2. a. b. c. d. e. f. g. h. i. j. k. l.

Elderly Physically Disabled Special Olympics Citizens with Intellectual Disabilities Human Needs Pro-Life Programs Victims of Disasters Hospitals/Institutions Health and Service Organizations Community wide Projects Habitat for Humanity Miscellaneous

Total Community Disbursements 8

DOLLARS ONLY:

Columbian Squires Scouting Youth Groups Youth Welfare/Services Athletics Scholarships/Education Miscellaneous

, , , , , , ,

Total Youth Disbursements

, ,

, , , , ,

3. a. b. c. d. e. f. g.

TOTAL CHARITABLE (CHURCH, COMMUNITY, YOUTH) DISBURSEMENTS IV. FRATERNAL COMMITMENT: 1. Number of visits to: a. Sick b. Bereaved

Total Visits 2. Number of blood donors 3. Habitat for Humanity

Estimated hours of volunteer service: 4. a. Church b. c. d. e.

Community Youth Habitat for Humanity Miscellaneous

DOLLARS ONLY:

, , , , , , , , , , , ,

Total Volunteer Hours Estimated hours of fraternal service: 5. Sick/disabled members and their families

(Signed) __________________________________________________________ (Chief Squire)

(Signed) __________________________________________________________ (Burser)

Date: ____________________________________________________________ FORWARD TO: Supreme Council Department of Fraternal Services. COPY TO: State Deputy, State Squires Chairman, Circle File. 1728C 1/07

Detach and mail to: Knights of Columbus Supreme Council Office, Department of Fraternal Services 1 Columbus Plaza, New Haven, CT 06510-3326 or Fax to: (203) 752-4108

I. NUMBER OF MEETINGS HELD DURING YEAR:

state/province

COLUMBIAN SQUIRES CIRCLE SEMIANNUAL STATUS AND AUDIT REPORT FOR PERIOD JULY 1 – DECEMBER 31, 20___ Due By: MARCH 1

Detach and mail to: Knights of Columbus Supreme Council Office, Department of Fraternal Services 1 Columbus Plaza, New Haven, CT 06510-3326 or Fax to: (203) 752-4108

CIRCLE No. _______________ CITY _______________________________________ STATE/PROVINCE ____________

_____________________________________________________________________________________________ SECTION 1 CIRCLE STATUS _____________________________________________________________________________________________ M is active

The circle:

M is inactive, but is being reorganized M is inactive, please remove from active status During this six month period, the circle held meetings/activities: M regularly

M infrequently

M not at all

Date of most recent circle meeting/activity: ________________________________________ Number of Squires attending: ____________________________________________________ Number of counselors attending: _________________________________________________ The circle has a regular meeting location: M yes

M no

The circle’s current chief counselor is: Name ______________________________________________________________________________ Address ____________________________________________________________________________ Town/City _________________________________________________ State/Province ______________ Postal Code ___________________ The circle has ________________ active counselors. List your circle’s strengths and weaknesses: __________________________________________________________________________________ _______________________________________________________________________________________________________________________ List any suggestions for improving the Columbian Squires program materials, activities, policies, forms, procedures, etc.: _________________ _______________________________________________________________________________________________________________________ M Yes

M No A copy of “Squires Newsletter/Major Activity Report” (Form # 363, pages 21-22 of the Circle Report Forms Booklet) is enclosed.

_____________________________________________________________________________________________ SECTION 2 MEMBERSHIP STATUS ____________________________________________________________________________________________ ADDITIONS

DEDUCTIONS

Total Members July 1, 20___

__________________

Suspensions

__________________

New Members

__________________

Deaths

__________________

Transfers into circle

__________________

Permanent Removals

__________________

Transfers to other circles

Reinstatements Total for Period

__________________

Minus Total Deductions

__________________

Number Members December 31, 20___

247-NC 1/07

Total Deductions

__________________ __________________

__________________

FOR PERIOD JULY 1 – DECEMBER 31, 20___

____________________________________________________________________________________________ SECTION 3 SCHEDULE A — CASH TRANSACTIONS ____________________________________________________________________________________________ Bursar Disbursements Cash on Hand July 1, 20___ Interest Earned on Investments Cash Received-Dues, Initiations Cash Received from other Sources: (Explain Kind and Amount) ___________________________$ ___________ ___________________________$ ___________ ___________________________$ ___________ Total Cash Received Less Total Disbursements Net Balance on Hand December 31, 20___

$ __________________ $ __________________ $ __________________

Per Capita:

Supreme Council State Circle General Circle Expenses Miscellaneous Total Disbursements

$ __________________ $ __________________ $ __________________ $ __________________ $ __________________ __________________

$ __________________ $ __________________ $ __________________ __________________

____________________________________________________________________________________________ SCHEDULE B — ASSETS AND LIABILITIES ____________________________________________________________________________________________ ASSETS

LIABILITIES

Cash: Undeposited Funds Bank — General — Acct. — Special Acct. — Savings & Invest. Acct. Due from _________ Members (number) Total Current Assets

$ __________________ $ __________________ $ __________________ $ __________________ $ __________________ $ __________________ __________________

Less Total Current Liabilities Net Current Assets

$ __________________ $ __________________ __________________

Due to Supreme Council: Per Capita Supplies Other Due to State Circle Advance Payments by _____ Members (number) Misc. Liabilities: __________________________ __________________________ __________________________ Total Current Liabilities

$ __________________ $ __________________ $ __________________ $ __________________ $ __________________ $ __________________ $ __________________ $ __________________ $ __________________ $ __________________ __________________

Circle Advisory Committee Statement Signed this _______________________ day of _______________________ 20 _____

Grand Knight _____________________________________________________ Please complete all items. Insert “None” where no figures are to be shown. FORWARD TO: Supreme Secretary State Squire Chairman

Deputy Grand Knight ______________________________________________ Chief Counselor ___________________________________________________ Chief Squire ______________________________________________________

COPY TO: Circle File

247-NC 1/07

REFUND SUPPORT VOCATIONS PROGRAM (RSVP)

Due By: JUNE 30 Detach and mail to: Knights of Columbus Supreme Council Office, Department of Fraternal Services 1 Columbus Plaza, New Haven, CT 06510-3326 or Fax to: (203) 752-4108

(Please review these guidelines before completing application form on reverse) The Knights of Columbus launched the Refund Support Vocations Program (RSVP) in 1981. Under this program, Squires circles agree to make an annual contribution of $100 or more to an individual seminarian to help with his expenses. Circles can sponsor more than one seminarian if their resources permit. In each case, the minimum annual contribution is $100 per seminarian. For every $100 donated, the circle is eligible for a refund of $20 from the Supreme Council. The maximum refund a circle can receive is $400 per individual supported.

The following persons are eligible to receive RSVP funds: • • • • •

Seminarians who have been accepted by a diocese and are currently in their “spirituality” year; Seminarians attending major seminaries (usually, four years) in preparation for priestly ordination; Seminarians in their “pastoral” year (most often, when they are deacons); Seminarians attending college seminaries (sometimes called minor seminaries); Seminarians who belong to a religious institute and are currently in formation for the priesthood (religious seminarians often are called “Brother” even though they will eventually be ordained as priests); and • Men and women who are novices or postulants in religious orders or religious communities. Those eligible for assistance do include foreign seminarians studying in the United States or Canada; U.S. or Canadian seminarians studying overseas; seminarians from your home diocese currently attending seminaries in another diocese, state, or country; and seminarians from other states or dioceses attending a seminary located in your jurisdiction.

Persons not eligible for RSVP funds are the following: • Priests or religious seeking assistance for continuing education; • Religious brothers not currently studying for the priesthood; and • Candidates for the permanent diaconate.

SECTIONS I AND II MUST BE COMPLETED TO BE ELIGIBLE FOR THE RSVP PLAQUE DIRECTIVES FOR SECTION I: (RSVP) REFUND INFORMATION N.B. To qualify for the refund, the following conditions must be met: a) Money given to each individual must be vocation-related, donated between July 1 and June 30 within the fraternal year applied for and must amount to at least $100 per individual. b) The money must have been given to an individual and NOT to an institution or fund. c) Money must be given to a seminarian, postulant or novice only. d) The money must be paid with a check drawn on the circle account. e) Copies of any cancelled checks (both front and back sides) or other documentation must be attached to this application.

DIRECTIVES FOR SECTION II: (RSVP) MORAL SUPPORT INFORMATION Substantial moral support is required. This would include some or all of the following: a) Correspondence between circle and seminarian/postulant b) Personal visits to seminary or religious residence c) Invitation of seminarian/postulant to circle events d) Similar signs of interest.

REFUND SUPPORT VOCATIONS PROGRAM (RSVP) REFUND AND PLAQUE APPLICATION 20___-20___ Due By: JUNE 30 Important: Please complete this box:

For Office Use Only

State/Province __________________________ Circle No. _________________________ Ref $ ___________________________________

Location ___________________________________________________________________ (city)

Y. St. ___________________________________ Circle Name _______________________________________________________________ Date ___________________________________

Chief Squire ________________________________________________________________

SECTIONS I AND II MUST BE COMPLETED TO BE ELIGIBLE FOR THE RSVP PLAQUE SECTION I: REFUND INFORMATION See directives on the reverse side before completing this section.

List each grant of $100 or more with name, amount and date of check. Attach copies of cancelled checks (both front and back sides) or other documentation to this application. SEMINARIAN/POSTULANT

FORMER SQUIRE ?

ADDRESS

CITY/STATE

ZIP

DATE

CHECK #

AMOUNT

NAME OF SEMINARY/CONVENT

......................................................................................................................................................................................................................

SECTION II: MORAL SUPPORT INFORMATION See directives on the reverse side before completing this section.

Examples of moral support must be provided in order to receive plaque or date plate. __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ __________________________________________________________________________________________________________ IMPORTANT: Be sure to check off one of the following: We already have a Vocations Plaque and require only an adhesive date plate for 20___-20___. This is our first year with RSVP and we require both a Vocations Plaque and an adhesive date plate for 20___-20___. Our Vocations Plaque is full and we require a new one. I AFFIRM THE ABOVE TO BE ACCURATE: _________________________________________________________________________________________ Chief Squire

Date: ________________________________________________

MAIL ORIGINAL TO: Supreme Council Department of Fraternal Services COPIES TO: State Vocations Chairman, Circle File (See other side for instructions)

2863 1/07

CORPS d’ELITE AWARD ESTO

C S K

APPLICATION DUE BY: JUNE 30

Detach and mail to: Knights of Columbus Supreme Council Office, Department of Fraternal Services 1 Columbus Plaza, New Haven, CT 06510-3326 or Fax to: (203) 752-4108

Circle # ____________________________________ Sponsoring Council/Assembly # ________________________

Location ___________________________________ (City)

____________________________________________ (State or Province)

1. Complete and return the “Officers, Chairmen and Counselors Report” (Form #468-NC) to the Supreme Council office by August 1. (New circles instituted after July 1 need not meet this requirement.) 2. Annually conduct and report at least four (4) major involvement activities in each of the following areas of the Squires program: spiritual, service, circle and membership. 3. Pay July 1 per capita tax on or before October 10. Pay January 1 per capita tax on or before April 10. 4. Complete and return the “Annual Survey of Fraternal Activity” (Form #1728C) to the Supreme Council office by January 31. (New circles instituted after July 1 need not meet this requirement.) 5. Achieve net gain of at least two (2) members by June 30. Attainment of the circle membership quota will be determined through receipt of membership documents processed and recorded at the Supreme Council office between July 1 and June 30. The circle notary must complete the additional information needed in this application. Each application must be signed by the notary, chief squire and chief counselor. When the application is completed, return immediately to: Columbian Squires, Knights of Columbus Department of Fraternal Services, 1 Columbus Plaza, New Haven, CT 06510-3326. This application must be received in the Supreme Council office by June 30.

SPIRITUAL ACTIVITIES 1. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 2. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 3. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 4. __________________________________________________________________________________________________ __________________________________________________________________________________________________

SERVICE ACTIVITIES 1. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 2. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 3. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 4. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 278 1/07

CIRCLE ACTIVITIES 1. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 2. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 3. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 4. __________________________________________________________________________________________________ __________________________________________________________________________________________________

MEMBERSHIP ACTIVITIES 1. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 2. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 3. __________________________________________________________________________________________________ __________________________________________________________________________________________________ 4. __________________________________________________________________________________________________ __________________________________________________________________________________________________

Signed:

__________________________ Notary

Attest:

__________________________ Chief Squire

Attest:

__________________________ Chief Counselor

Date: ____________________________

This Area for Supreme Council Office Use Only

Form #468-NC Received ______________________ July Per Capita Tax Paid ______________________ January Per Capita Tax Paid __________________ Form #1728C Received

______________________

Award Application Received ____________________ Membership Quota Attained ____________________ Acknowledged ________________________________

Forward Original To: Supreme Council Department of Fraternal Services Copy To: State Squires Chairman, Circle File

BROTHER BARNABAS AWARD APPLICATION DUE BY: JUNE 30

Detach and mail to: Knights of Columbus Supreme Council Office, Department of Fraternal Services 1 Columbus Plaza, New Haven, CT 06510-3326 or Fax to: (203) 752-4108

The Brother Barnabas Award recognizes the 25 best activities conducted by local circles throughout the United States, Canada, Mexico, the Philippines, Puerto Rico, the Bahamas, the Virgin Islands and Guam. Circles may submit more than one application for award consideration per year. This form may be reproduced or additional forms may be obtained online at www.kofc.org/squires or from the Supreme Council Supply Department. Only one entry per form! To qualify for competition, completed entries must be received at the Supreme Council office by June 30. Complete and mail to: Columbian Squires, Knights of Columbus Department of Fraternal Services, 1 Columbus Plaza, New Haven, CT 06510-3326. CIRCLE NUMBER:

__________________________________

COUNCIL NUMBER:____________________

CIRCLE NAME: __________________________LOCATION: (Town or City)

(State or Province)

The information which follows describes a single activity conducted by our circle and serves as our entry in the Supreme Council’s “Brother Barnabas Award Contest.” Project Title: ________________________________________________________________________________________ Date Project Conducted: Purpose of Activity:

____________________________________________________________________________

________________________________________________________________________________

Number of circle members participating in project: ____________________________________________________ Total number of people participating in project: ________________________________________________________ .................................

% Percentage of circle members participating in project: . __________________________________________________ ........................... Number of man hours expended in project: .____________________________________________________________ ................................... Funds raised: $ ________________________ Funds donated to: ____________________________________________ Amount: $

______________________________________________ Amount: $

Chairman’s Name:_____________________________________ Telephone Number: ___________________________ Describe project in detail — use additional paper, if necessary. (Photographs, news clippings, scrapbook, etc. may be included with this reporting form. Do not send videotapes or CD’s, which will not be reviewed.) ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ See page 18 of the Columbian Squires Circle Operations Manual and Executive Leadership Guide (#498) for Brother Barnabas Award judging criteria. Note: If a circle program has been recognized as a Brother Barnabas award winning activity in the past, it should not be submitted again, since a similar program conducted by the same circle is eligible for a Brother Barnabas Award only once. Attest: ______________________________________ _______ Signed: ________________________________________ (Chief Squire)

279 1/07

MAIL ORIGINAL TO: Department of Fraternal Services Knights of Columbus 1 Columbus Plaza New Haven, CT 06510-3326

Date

(Chief Counselor)

COPIES TO: State Squires Chairman, Circle File

CIRCLE OFFICERS AND CHAIRMEN FOR THE TERM JULY 1, 20___ TO JUNE 30, 20___ Circle #

Co/Asm #

DUE BY: AUGUST 1

PLEASE PRINT – INDICATE MEMBERSHIP NUMBERS

Detach and mail to: Knights of Columbus Supreme Council Office, Department of Membership Records 1 Columbus Plaza, New Haven, CT 06510-3326 or Fax to: (203) 752-4113

MEETING LOCATION ADDRESS

DATE OF ELECTION ADDITIONAL ADDRESS

STREET CITY

MEMBERSHIP NO.

CHIEF SQUIRE

POSTAL CODE

LAST NAME

FIRST NAME

TELEPHONE NUMBER

INITIAL

E-MAIL ADDRESS

ADDRESS MEMBERSHIP NO.

FATHER PRIOR TELEPHONE NUMBERS:

LAST NAME

RESIDENCE

FIRST NAME

INITIAL

E-MAIL ADDRESS

BUSINESS

ADDRESS

MEMBERSHIP NO.

DEPUTY CHIEF SQUIRE

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

E-MAIL ADDRESS

MEMBERSHIP NO.

NOTARY

E-MAIL ADDRESS

MEMBERSHIP NO.

BURSAR

E-MAIL ADDRESS

MEMBERSHIP NO.

SPIRITUAL CHAIRMAN

E-MAIL ADDRESS

MEMBERSHIP NO.

SERVICE CHAIRMAN

E-MAIL ADDRESS

MEMBERSHIP NO.

CIRCLE CHAIRMAN

E-MAIL ADDRESS

MEMBERSHIP NO.

MEMBERSHIP CHAIRMAN

E-MAIL ADDRESS

OUR CIRCLE... HAS ITS OWN CEREMONIAL TEAM IS

❏

COUNCIL

❏

CHURCH

❏ YES ❏ ❏ SCHOOL

MEETS FORM 468 – 1/07

DAY

TIME

❏

MILITARY-BASED 17

CIRCLE COUNSELORS List below the Knights who have been appointed to the positions of chief counselor and counselor in the Squires circle. Each Knight who has been appointed to the position of chief counselor or counselor must have a current, approved Youth Leader application (Form #4348) on file at the Supreme Council office. If he does not, he must complete a Youth Leader Form #4348 and submit it to the grand knight/faithful navigator. Priests serving as father prior are exempt from submitting Form #4348. Priests are also exempt if they are serving as chief counselor or as a counselor, and their status as a priest should be indicated by checking the “Priest” box next to their entry. YOUTH LEADER FORM #4348

CHIEF COUNSELOR

(Check One) SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. TELEPHONE NUMBERS:

LAST NAME RESIDENCE

FIRST NAME BUSINESS

INITIAL FAX

ADDRESS E-MAIL ADDRESS

YOUTH LEADER FORM #4348

COUNSELORS

(Check One) SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO.

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

LAST NAME

FIRST NAME

INITIAL

E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

SUBMITTED TO GK/FN

ON FILE

PRIEST MEMBERSHIP NO. E-MAIL ADDRESS

signed NOTARY

FORWARD TO: Knights of Columbus Department of Membership Records 1 Columbus Plaza 18 New Haven, CT 06510–3326

DATE

CHIEF COUNSELOR

COPIES TO: State Squires Chairman, Grand Knight, Circle File

DATE

COLUMBIAN SQUIRES CIRCLE SEMIANNUAL STATUS AND AUDIT REPORT FOR PERIOD JANUARY 1 – JUNE 30, 20___ Due By: SEPTEMBER 1 Detach and mail to: Knights of Columbus Supreme Council Office, Department of Fraternal Services 1 Columbus Plaza, New Haven, CT 06510-3326 or Fax to: (203) 752-4108

CIRCLE No. _______________ CITY _______________________________________ STATE/PROVINCE ____________

The circle:

M is inactive, but is being reorganized M is inactive, please remove from active status During this six month period, the circle held meetings/activities: M regularly

M infrequently

M not at all

M no

The circle’s current chief counselor is: Name ______________________________________________________________________________ Address ____________________________________________________________________________ Town/City _________________________________________________ State/Province ____________ Postal Code ___________________ The circle has ________________ active counselors. List your circle’s strengths and weaknesses: _________________________________________________________________________________ _______________________________________________________________________________________________________________________ List any suggestions for improving the Columbian Squires program materials, activities, policies, forms, procedures, etc.: ________________ _______________________________________________________________________________________________________________________ M Yes

M No A copy of “Squires Newsletter/Major Activity Report” (Form # 363, pages 21-22 of the Circle Report Forms Booklet) is enclosed.

_______________________________________________________________________________________________________________________ ____________________________________________________________________________________________ MEMBERSHIP STATUS SECTION 2 ____________________________________________________________________________________________

ADDITIONS

DEDUCTIONS

Total Members January 1, 20___

__________________

Suspensions

__________________

New Members

__________________

Deaths

__________________

Transfers into circle

__________________

Permanent Removals

__________________

Reinstatements

__________________

Transfers to other circles

__________________ __________________

Total for Period

__________________

Total Deductions

Minus Total Deductions

__________________

Number of 18 year old Squires removed from circle roster July 1, 20___

Number Members June 30, 20___

247-NC 1/07

________________

____________________

FOR PERIOD JANUARY 1 – JUNE 30, 20___

_____________________________________________________________________________________________ SECTION 3 SCHEDULE A — CASH TRANSACTIONS _____________________________________________________________________________________________ Bursar Disbursements Cash on Hand January 1, 20___ Interest Earned on Investments Cash Received-Dues, Initiations Cash Received from other Sources: (Explain Kind and Amount) ___________________________$ ___________ ___________________________$ ___________ ___________________________$ ___________ Total Cash Received Less Total Disbursements Net Balance on Hand June 30, 20___

$ __________________ $ __________________ $ __________________

Per Capita:

Supreme Council State Circle General Circle Expenses Miscellaneous Total Disbursements

$ __________________ $ __________________ $ __________________ $ __________________ $ __________________ __________________

$ __________________ $ __________________ $ __________________ __________________

LIABILITIES

Cash: Undeposited Funds Bank — General — Acct. — Special Acct. — Savings & Invest. Acct. Due from _________ Members Total Current Assets

$ __________________ $ __________________ $ __________________ $ __________________ $ __________________ $ __________________ __________________

Less Total Current Liabilities Net Current Assets

$ __________________ $ __________________ __________________

Due to Supreme Council: Per Capita Supplies Other Due to State Circle Advance Payments by _____ Members Misc. Liabilities: __________________________ __________________________ __________________________ Total Current Liabilities

Circle Advisory Committee Statement Signed this _______________________ day of _______________________ 20 _____ Please complete all items.

Grand Knight ____________________________________________________

Insert “None” where no figures are to be shown.

Deputy Grand Knight ______________________________________________

FORWARD TO: Supreme Secretary State Squires Chairman COPY TO: Circle File

Chief Counselor __________________________________________________ Chief Squire ____________________________________________________

247-NC 1/07

SQUIRES NEWSLETTER/MAJOR ACTIVITY REPORT

Detach and mail to: Knights of Columbus Supreme Council Office, Department of Fraternal Services 1 Columbus Plaza, New Haven, CT 06510-3326 or Fax to: (203) 752-4108

Circle Name

Circle Number

Circle Location

City, State/Province

Use this form to report major activities to the Supreme Council office for possible use in SQUIRES NEWSLETTER. Photographs and newspaper clippings describing the project may be attached to this report. DUPLICATE BEFORE COMPLETING. SAVE THIS ORIGINAL FOR FUTURE USE. PROGRAM ORGANIZED BY: (mark only one) M SPIRITUAL ACTIVITIES M SERVICE ACTIVITIES COMMITTEE COMMITTEE

M CIRCLE ACTIVITIES

COMMITTEE

If available, place photo here.

Use scotch tape only on reverse side of photo.

M MEMBERSHIP ACTIVITIES

COMMITTEE Project Title: ______________________ __________________________________ Number of Squires attending activity: __________________________ Number of non-Squires attending activity: __________________________

No. of Squire manhours: _____________ Do not staple or write on photo. Use cardboard inserts.

The Supreme Council office will credit the circle $25 if the photo is used in SQUIRES NEWSLETTER.

Amount of money raised: $ ___________

Organizations receiving charitable donations from activity profits: Amount donated: $ __________________

List photo caption here (be sure to provide names and titles, left to right, for all people in photo):

__________________________________ __________________________________ Amount donated: $ __________________

________________________________________________________ ________________________________________________________

__________________________________ __________________________________

Please print all information ACTIVITY DESCRIPTION (provide as much detail as possible)

Why was the activity conducted? ________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ When was the activity conducted? ______________________________________________________________________ Where was the activity conducted? ______________________________________________________________________ Who participated in the activity? ________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ (Continue activity description on back of form)

What did the committee do to organize the activity? ____________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ Highlights of activity: ____________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ Describe any publicity activity received (attach copy of newspaper clippings, etc.): __________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ Committee Chairman’s Name: ______________________________________

________________________________________________ (Notary’s Signature)

Telephone: (______) ____________________________________

________________________________________________ (Chief Counselor’s Signature)

Address: ______________________________________________

( _______________________________________________ )

(street address)

(Chief Counselor’s Telephone)

______________________________________________________ (town/city)

(state/province)

Original to: Editor – Squires Newsletter Knights of Columbus 1 Columbus Plaza New Haven, CT 06510 – 3326

(zip/postal code)

Copy to: Circle File

363 1/07