MEMBER/PROSPECT INTEREST SURVEY - Knights …

1 MEMBER/PROSPECT INTEREST SURVEYSERVICE PROGRAM INVOLVEMENTWe value your judgment, we appreciate your opinions, and we rely on your participation for our continued success. OurKnights of Columbus council conducts a variety of programs programs where you can personally apply your talents andfulfill your ambitions. In an effort to satisfy your desires and interests, we ask that you complete the following list your preferences for possible committee those areas which you find exciting, challenging and you are a current member, in your opinion, how can our council improve existing programs?

2 Please be you are a prospective member, what do you expect from your membership in our council? _____PROGRAMSMEMBERSHIPCHURCHV ocations/RSVPP arochial ServicesReligious DevotionsLay ApostolateParish Round TableChrist in ChristmasBuilding theDomestic ChurchOther, Specify: RecruitmentCOMMUNITYH ealth ServicesCivic InvolvementDecencyGlobal WheelchairMissionPublic SafetyHabitat for HumanityOther, Specify: COUNCILP ublic RelationsFraternalismBlood DonorsSpecial OlympicsAthleticsCultural EventsOther, Specify: FAMILYS urvivor s AssistanceFamily of the Month/YearMemorialsEducationFood for FamiliesCommunicationsRecreationOther, Specify: CULTURE OF LIFEBaby Bottle CampaignPro-Life Baby ShowersMemorials to theUnbornUltrasound InitiativeMarch for LifeOther, Specify: RetentionInsurance PromotionCeremonialsAdmission CommitteeYOUTHC olumbian SquiresYouth GroupsEducational ProgramsAthleticsReligious ActivitiesSocial ActivitiesCoats for KidsOther, Specify: 1842 5/15 GENERAL INFORMATION Date.

3 _____Name: _____Street Address: _____City: _____ State or Province: _____ Zip/Postal Code: _____Home Phone: _____ Cell Phone: _____ E-Mail _____Marital Status: Married Single WidowerIf Married, Wife s Name: _____No. of Children: Boys ____ Girls ____Occupation: _____ Name of Employer: _____Church/Parish: _____Hobbies/Interests: _____