All information provided on this
report is to be from Programs
& Activities conducted
January 1
December 31
Due January 31
Submit form to:
1. Regular
2. Social
3. Special/Committee
Other Fraternal Commitments (where applicable)
Visits to the Sick
Visits to the Bereaved
Number of Blood Donations
Masses Held for Members
Hours of Fraternal Service to
Sick/Disabled Members and their Families
Faith Activities (where applicable)
a. Refund Support Vocations Program
b. Church Facilities
c. Catholic Schools/Seminaries
d. Religious/Vocations Education
e. Prayer & Study Programs
f. Sacramental Gifts
g. Miscellaneous Faith Activities
Community Activities (where applicable)
a. Coats For Kids
b. Global Wheelchair Mission
c. Habitat for Humanity
d. Disaster Preparedness/Relief
e. Physically Disabled/Intellectual Disabilities
f. Elderly/Widow(er) Care
g. Hospitals/Health Organizations
h. Columbian Squires
i. Scouting/Youth Groups
j. Athletics
k. Youth Welfare/Service
l. Scholarships/Education
m. Veteran Military/VAVS
n. Miscellaneous Community/Youth Activities
Life Activities (where applicable)
a. Special Olympics
b. Marches for Life
c. Ultrasound Initiative
d. Pregnancy Center Support
e. Christian Refugee Relief
f. Memorials to Unborn Children
g. Miscellaneous Life Activities
Family Activities (where applicable)
a. Food for Families
b. Family Formation Programs
c. Keep Christ in Christmas
d. Family Week
e. Family Prayer Night
f. Miscellaneous Family Programs
of Service
Grand Knight Date
Financial Secretary Date
Section I.Fraternal Program Activities
Section II.Fraternal Commitment Activities
Due January 
Page 1 of 2
Member #
Member #
Annual Survey
of Fraternal Activity
January 1, 20
through December 31, 20
Council Number
Faith Activities
a. Refund Support Vocations Program - direct contributions to students studying to become priests or postulants.
b. Church Facilities - construction, repairs, remodeling, memorial gifts, etc.
c. Catholic Schools/Seminaries - donations, grants, equipment, etc.
d. Religious/Vocations Education - scholarships, CCD, lay apostolate, programs, speakers, films, program materials, etc.
e. Prayer & Study Programs - direct contributions to prayer groups, faith program materials, domestic church kiosk, rosary program, Marian Icon
program, etc.
f. Sacramental Gifts - costs related to gifts presented to congregation.
g. Miscellaneous Faith Activities - all other disbursements not outlined above relating to Faith Activities.
Family Activities
a. Food for Families - direct contributions to food banks, pantries, soup kitchens.
b. Family Formation Programs - Family Fully Alive, Family of the Month/Year, Consecration to the Holy Family, Good Friday Family Promotion, etc.
c. Keep Christ in Christmas - all contributions to KCIC, Journey to the Inn, Light Up for Christ, Christmas Poster Contest, billboard signs, etc.
d. Family Week - direct contributions to the coordination, promotion, and conduct of this program.
e. Family Prayer Night - direct contributions to coordination and execution of this program.
f. Miscellaneous Family Programs - all other disbursements not outlined above relating to Family Activities.
Community Activities
a. Coats For Kids - direct contributions to purchasing and distribution of coats to those in need.
b. Global Wheelchair Mission - direct contributions to purchasing and coordination of wheelchair distribution to the needy.
c. Habitat for Humanity - direct contributions to Habitat for Humanity projects, materials, tools, and construction.
d. Disaster Preparedness/Relief - direct contributions to planning and executing disaster preparedness and response, food, water, equipment, etc.
e. Physically Disabled/Intellectual Disabilities - direct contributions to schools, care services, organizations, etc.
f. Elderly/Widow(er) Care - direct contributions to homes for the aged, retired/senior volunteer programs, construction, repairs, remodeling, gifts, etc.
g. Hospitals/Health Organizations - direct contributions to Red Cross, Hospice, heart/cancer funds, equipment, construction, donations, etc.
h. Columbian Squires - direct contributions to the operations and support of the Columbian Squires program.
i. Scouting/Youth Groups - direct contributions to sponsorship, volunteer efforts, projects, 4-H, Big Brothers, CYO, mentoring, etc.
j. Athletics - direct contributions to council sport events, youth sport sponsorships, equipment, transportation, etc.
k. Youth Welfare/Service - direct contributions to substance/child abuse, foster parents, etc.
l. Scholarships/Education - direct contributions to career nights, essay contests, scholarships, tuition, fund raising, etc.
m. Veteran Military/VAVS - direct contributions to veterans, VA hospital support/visitation, memorials, parades, etc.
n. Miscellaneous Community/Youth Activities - all other disbursements not outlined above relating to Community Activities.
Life Activities
a. Special Olympics - direct contributions to local, state, and national events.
b. Marches for Life - direct contributions to local, state, and nation marches.
c. Ultrasound Initiative - direct contributions to the purchase and placement of Ultrasound machines for crisis pregnancy centers.
d. Pregnancy Center Support - direct contributions to donations, diapers, supplies, baby showers, birthright, etc.
e. Christian Refugee Relief - direct contributions to aid provided to refugee relief, Solidarity Crosses.
f. Memorials to Unborn Children - direct contributions to purchases, fund raisers, donations, construction, etc.
g. Miscellaneous Life Activities - all other disbursements not outlined above relating to Life Activities.
. Business - discussing or conducting business.
. Social - dinners, dances, parties, etc.
. Special/Committee - lectures, films, educational, etc.
Section I.Fraternal Program Activities
Section II.Fraternal Commitment Activities
Page 2 of 2
Submission Due Date is January 
Annual Survey of Fraternal Activity