Date _________________________________________ Council No. _________________________________________
City ______________________________________________ State or Province _______________________________________________
365 11/11
Form (#365) should be completed and forwarded to the Supreme Council Department of Fraternal Services as soon as a majority of your council’s
Service Program personnel have been appointed. Please understand that it is not necessary for your council to appoint members to fill all of the
positions listed below. Because of local circumstances, a council may wish to only appoint the seven directors and perhaps a few chairmen to
conduct those programs needed in your area. When and if additional chairmen are appointed, they should be reported promptly to the Depart-
ment of Fraternal Services.
Please print or type names and membership numbers for those directors and/or chairmen appointed for your council. Failure to include membership
numbers will only delay the pr
ocessing and receipt of special program materials which include KNIGHTLINE.
The Service Program Personnel Reporting Form (#365) must be received at the Supre
me Council office by August 1, in order to attain the first
requirement for the Star Council, Columbian, Father McGivney and Founders’ Awards.
If there are additions or deletions to your listing of Service Pr
ogram personnel during the fraternal year, please notify the Supreme Council
Department of Fraternal Services immediately at: 1 Columbus Plaza, New Haven, CT 06510-3326.
Due By:
AUGUST 1, 20__
For Supreme Office Use Only
Rec’d _______________________________________
MAIL ORIGINAL TO: Supreme Council Department of Fraternal Services
MAIL COPIES TO: State Deputy, District Deputy, Council File (Continued on Reverse)
Available in electronic format at www.kofc.org/forms
SERVICE PROGRAM PERSONNEL REPORT
20__-20__
CHAPLAIN: MEMBERSHIP NUMBER LAST NAME FIRST NAME INITIAL
EMAIL
PROGRAM DIRECTOR: MEMBERSHIP NUMBER LAST NAME FIRST NAME INITIAL
EMAIL
CHURCH DIRECTOR: MEMBERSHIP NUMBER LAST NAME FIRST NAME INITIAL
EMAIL
VOCATIONS CHAIRMAN: MEMBERSHIP NUMBER LAST NAME FIRST NAME INITIAL
EMAIL
COMMUNITY DIRECTOR: MEMBERSHIP NUMBER LAST NAME FIRST NAME INITIAL
EMAIL
CULTURE OF LIFE DIRECTOR: MEMBERSHIP NUMBER LAST NAME FIRST NAME INITIAL
EMAIL
HEALTH SERVICES: MEMBERSHIP NUMBER LAST NAME FIRST NAME INITIAL
EMAIL
COUNCIL DIRECTOR MEMBERSHIP NUMBER LAST NAME FIRST NAME INITIAL
EMAIL
PUBLIC RELATIONS: MEMBERSHIP NUMBER LAST NAME FIRST NAME INITIAL
EMAIL
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