Fillable Family of the Year Entry Form INSTRUCTIONS Local (Knights of Columbus)

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Family of the Year Entry Form INSTRUCTIONS Local (Knights of Columbus)

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Family of the Year
Entry Form
Council/Jurisdiction: _________________________________________________________ Date: _________________
INSTRUCTIONS
Local Councils: To enter your Family of the Year into jurisdiction competition, complete this form and forward it to the
state deputy. Additional paper may be used if space allocated is not sufficient. Photographs, news clippings, letters of
commendation or other special exhibits may be included. Note: Individual jurisdictions set their own deadlines for
state/provincial competitions, so watch for deadline dates or contact the state deputy, state program director, or state
family director.
A. PERSONAL DATA
Member’s Name: ___________________________________________   ___________________________
(Membership Number)
Wife’s Name: ______________________________________________
Children/Ages: Children/Ages:
_______________________________________________ ______________________________________________
_______________________________________________ ______________________________________________
_______________________________________________ ______________________________________________
Home Address: ____________________________________________________________________________________
Home Telephone: __________________________________ Business Telephone: _____________________________
Parish: __________________________________________ Pastor: _______________________________________
Address: ________________________________________________ Telephone: _____________________________ 
B. KNIGHTS OF COLUMBUS DATA
Family nominated by Council __________________ in ____________________________________________________
(Number) (Location)
For how many years has husband/father been a member of the Knights of Columbus? _____________________________
Positions (offices/program directorships/chairmanships/committee assignments) held:
continued on back
Family
Faith in Action
Faith in Action
Family
Explain the entire family’s involvement within the Knights of Columbus: 
C. FAMILY INVOLVEMENT
Explain the entire family’s involvement within the Church: 
Explain the entire family’s involvement within the community: 
Explain why this family was chosen as the model family in your jurisdiction. Why does this family deserve the distinction of
being named Knights of Columbus Family of the Year?
10680 2/21
(Councils should retain a copy of this completed form for their files)
FOR JURISDICTION USE ONLY:
This family has been chosen Jurisdiction Family of the Year.
Attest: _________________________________________________________________________________
(State Deputy)
If this entry is selected as the Jurisdiction Family of the Year, please submit this winning entry form with the state deputy’s
signature or e-signature and all collateral material to the Supreme Council Department of Fraternal Mission along
with your SPAW/STSP packet of International Award Winners. It is preferred that these be submitted electronically
to fraternalmission@kofc.org. Jurisdiction Family of the Year submissions are due by June 1 for consideration in the
International Family of the Year competition.
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Family of the Year Entry Form INSTRUCTIONS Local (Knights of Columbus)

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Completed 28 December 2022

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