APPLICATION FOR APPOINTMENT AS
FINANCIAL SECRETARY
WORTHY SUPREME KNIGHT:
Date: ________________
I am applying for appointment as Financial Secretary of my council.
Council Number: _____________ Council Location: ______________________________________________ ________________
City/Town State/Province
Full Name: _________________________________________________________ Membership Number: _____________________
Address: ______________________________________________________________________________________________________
City: ______________________________________________________ State/Province: ________ Postal Code:________________
Phone numbers: _______________________________ _______________________________ _______________________________
Home Business Cell
E-mail address ________________________________________________________________________________________________
1. I am on Supreme Office records as a member of Council Number: _____________________________________________
(Officers must be recorded members of the council in which they hold office.)
2. I am in good standing. Yes No
If No, explain: _____________________________________________________________________________________________
(Good standing means all council and other charges paid to end of past quarter year.)
3. I am a Third Degree member. Yes No
If No, explain: _____________________________________________________________________________________________
(Section 92 of the Laws requires officers to be in Third Degree, but permits officers of a new council to be in First Degree temporarily. If you are not in Third Degree today, explain above.)
4. Date of Birth: Month: _______ Day: _______ Year: _____________
5. My educational background is: ______________________________________________________________________________
6. I have served in the following offices of our Order:
(Office) (No. of Yrs) (Office) (No. of Yrs)
_____________________________________ _____________ _____________________________________ _____________
_____________________________________ _____________ _____________________________________ _____________
7. I currently hold the following COUNCIL OFFICE, from which I hereby resign immediately, if appointed Financial
Secretary by the Supreme Knight: ___________________________________________________________________________
8. My present major gainful occupation is (please indicate if retired):
Titles, duties or retired: ____________________________________________________________________________________
Name of employer: _________________________________________________________________________________________
Address of employer: _______________________________________________________________________________________
9. *I know I cannot be engaged in any way in the sale of personal accident, sickness, hospitalization, disability income
or life insurance. If I become so engaged while Financial Secretary, I will inform the Supreme Knight immediately.
(A member so engaged is not appointed or retained as Financial Secretary.)
*Statement 8 does not apply in Cuba, Guatemala, Panama, Canal Zone, Virgin Islands, Poland and Philippines.
10. I have had the following training or experience in accounting or bookkeeping:
___________________________________________________________________________________________________________
11. I have had these other experiences which might also help as Financial Secretary:
___________________________________________________________________________________________________________
12. Yes No If appointed Financial Secretary, I agree without reservation to fulfill all duties of that office in accor-
dance with the laws of the Order.
13. Yes No I understand that in my role as Financial Secretary I may obtain member’s personal information which
I pledge to maintain as confidential and only use for the business of the Order.
14. Yes No I understand that if appointed Financial Secretary such appointment shall be for a period of three years
with my performance in office subject to review before reappointment shall be made.
Applicant’s Signature_________________________________________________ Date____________________________________
Forward to: Knights of Columbus, Financial Secretary Div., P.O. Box 554, Elmsford, NY 10523-9906
or Financial.Secretary@KofC.org
or Fax to (203
) 752-4113
101 1
2/19
Please Do Not Write Here
Reset