Knights of Columbus - Membership Application

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Membership Document - Knights of Columbus
A Catholic, Family, Fraternal, Service Organization

When complete, please click on Print at the bottom of this page and drop off at any of the three churches.

1	Last Name	First Name	Initial	Rank or Title
	Street	Town	Prov	Postal Code
	Number of years at this address		e-mail

2 Telephone Date of Birth Marital Status

Occupation Soc. Ins. No. Employer

K of C Ins. Certificate Numbers Former Columbian Squire?

3 Are you a Practical Catholic in Communion with the Holy See? Yes
No Name of Parish

Did you apply for membership previously? Yes
No Degrees received and dates 1 2

3 4

4 Number of Last Council Location

Date of Termination of Membership

Reason for Termination

5 I hereby declare that the above is true and correct and that I will uphold the charter, constitution and laws of the Knights of Columbus and any of its councils in which I hold membership and agree that the decision of the Board of Directors shall control in all matters. I Agree

Yes No

2	Telephone	Date of Birth	Marital Status
	Occupation	Soc. Ins. No.	Employer
	K of C Ins. Certificate Numbers		Former Columbian Squire?

3	Are you a Practical Catholic in Communion with the Holy See?	Yes No	Name of Parish
	Did you apply for membership previously?	Yes No	Degrees received and dates	1	2
			Degrees received and dates	3	4

4	Number of Last Council	Location
	Date of Termination of Membership
	Reason for Termination

5	I hereby declare that the above is true and correct and that I will uphold the charter, constitution and laws of the Knights of Columbus and any of its councils in which I hold membership and agree that the decision of the Board of Directors shall control in all matters.	I Agree
		Yes No