NEW/RECEIVING COUNCIL NUMBER COUNCIL LOCATION (CITY, ST/PROV) MEMBERSHIP NUMBER DATE READ DATE ELECTED 1ST. DEG. DATE

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Membership DocumentA CATHOLIC, FAMILY, FRATERNAL, SERVICE ORGANIZATION

The member and officers’ signatures are required for this form to be processedPlease complete this form legibly

A copy of this form should be sent to the council agent for his records

1 COLUMBUS PLAZA, NEW HAVEN CT 06510

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LAST NAME FIRST NAME MIDDLE INITIAL TITLE

STREET CITY ST/PROV POSTAL CODE COUNTRY (OUTSIDE US)

DATE OF BIRTH MARITAL STATUS HOME PHONE BUSINESS PHONE CELL PHONEMO DAY YR

E-MAIL ADDRESS OCCUPATION/EMPLOYER LAST FOUR DIGITS OF TAX ID (e.g., SSN, SIN)

DATE OF TERMINATION REASON NUMBER OF LAST COUNCIL COUNCIL LOCATION (CITY, ST/PROV)

DID YOU APPLYFOR MEMBERSHIPPREVIOUSLY?

YES NO 1. FIRST 2. SECOND 3. THIRD 4. FOURTHINITIATIONDATES

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 HOLDMEMBERSHIP AND AGREE THAT THE DECISION OF THE BOARD OF DIRECTORS SHALL CONTROL IN ALL MATTERS.I AGREE THAT THE KNIGHTS OF COLUMBUS MAY VERIFY THE INFORMATION PROVIDED.

_____________________________________________________________________________________________________________SIGNATURE OF APPLICANT

DATE FINANCIAL SECRETARY SIGNATURES GRAND KNIGHT

SUPREME OFFICE COPY* SEE DEFINITION ON REVERSE/DOES NOT APPLY TO PRIESTS AND RELIGIOUS

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� NEW MEMBER

� JUVENILE TO ADULT

� REINSTATEMENT (up to 3 months)

� REACTIVATION (inactive insurance)

TRANSACTION � READMISSION (up to 7 years)

� REAPPLICATION (over 7 years)

� TRANSFER IN

� DATA CHANGE

� SUSPENSION__________________reason

I HEREBY RECOMMEND THE ABOVE APPLICANT FOR MEMBERSHIP.

PRINTED NAME OF PROPOSER __________________________________________________________________________________________________________

PROPOSER’S MEMBER NUMBER (required) _________________________________________________________________

100 3/15

*ARE YOU A PRACTICAL OR PRACTICING CATHOLIC IN UNION WITH THE HOLY SEE?

FORMERCOLUMBIANSQUIRE?

YES NO YES NOPARISH NAME, LOCATION (CITY, ST/PROV)

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MO DAY YR PROVIDE SURVIVOR INFORMATION BELOW

� DEATH____________________ NEXT OF KIN__________________________________

RELATIONSHIP___________________ TELEPHONE#___________________________

STREET_____________________________________________________________________

CITY_______________________ST/PROV________________ POSTAL CODE__________

FOR MORE INFORMATION VISIT KOFC.ORG OR CALL (203) 752-4473

K N I G H T S O F C O L U M B U S - 1 C O L U M B U S P L A Z A , N E W H A V E N , C O N N E C T I C U T

District DeputyReminder

J U L Y 2 0 1 5

CONGRATULATIONS ON YOURAPPOINTMENT

Congratulations on being appointed a DistrictDeputy. We wish you success in your efforts tobetter your district. The District Deputy

Reminder is a monthly newsletter designed to keep youinformed of important dates as well as upcomingOrderwide programs and other useful information.If you would like the District Deputy Reminder e-mailedto you on a monthly basis, please send an e-mail todd@kofc.org and we will add your e-mail address tothe monthly distribution list.

District Deputy

ORDERWIDE FIRST DEGREE WEEK

All councils should be preparing for theOrderwide First Degree Week scheduled forAugust 10 - 16, 2015. This is a good

opportunity for councils to welcome new membersinto their council after they’ve participated in theKnights of Columbus Family Week activities.

KNIGHTS OF COLUMBUS FAMILYWEEK AUG. 9 – 16, 2015

The Venerable Servant of God, Father Michael J.McGivney, founded the Knights of Columbus withfamily in mind.

K of C Family Week, August 9 - 16, should be of specialimportance this year as it falls during the preparation for the8th World Meeting of Families to be held in Philadelphia,September 22-27, 2015. Refer to the “Building theDomestic Church – The Family Fully Alive” (#10162)handbook for programming ideas and insight.

During this special week, join with your parish communityto celebrate the importance of families through a variety ofspiritual, educational or community oriented programs andactivities focused on children, spouses, grandparents orother extended family. Show the world that families are the backbone ofcommunities and of our Order by sponsoring andadvertising your council’s family events throughout the year.For more information, visit kofc.org/family week.

IMPORTANT REMINDERSReach out to each grand knight in your district, if•you haven’t already done so, to lay the foundationfor your relationship with him during the fraternalyear. Offer yourself as a resource for any questionshe may have. Communication is key —communicate early and often.Remind councils to submit the Report of Officers•Chosen for the Term (#185) and the ServiceProgram Personnel Report (#365) through theMember Management Application as soon aspossible.

NEW MEMBERSHIP DOCUMENT (#100)

The new Membership Document (#100) isapproved for use. Please inform all of thefinancial secretaries in your district to discard

any old Membership Documents (#100) and to beginusing the new Membership Document (#100)immediately.The new Membership Document (#100) can beordered through knightsgear.com.

FIFTH SUNDAY ROSARY PROGRAM

Encourage the councils in your district toconduct the new program — the Fifth SundayRosary Program. This program is designed

to encourage more involvement in Church activitiesby council members, their families and parishioners.The program should be conducted in the monthsthat contain five Sundays. Those months in the2015 - 2016 fraternal year are August, November,January and May.

Councils that wish to conduct this program shouldfirst consult with the local pastor or council chaplainin order to obtain permission to conduct the program

FOR MORE INFORMATION VISIT KOFC.ORG OR CALL (203) 752-4473

and to ensure there is no conflict with other scheduled parish activities.

Fifth Sunday Kits (#SR-KIT) are available through the Department of Fraternal Services. The kits consistof a finger rosary and prayer card. The prayer card contains instructions on how to pray the finger rosaryas well as the prayers and mysteries of the rosary. Personal rosaries may also be used when participatingin the program.

Councils conducting this program during the 2015-2016 fraternal year will fulfill all four Church Activityrequirements for the Columbian Award.

For additional information on the Fifth Sunday Rosary Program, please contact Jason Porrello at 203-752-4571 or jason.porrello@kofc.org.

NEW COUNCILS AND CIRCLES INSTITUTED LAST MONTH District DD Name Jurisdiction Council # Location3 Gregory A. Boggs South Dakota 16230 Tea5 Thai Q. Nguyen Virginia 16226 Hampton5 John J. Gravel Wisconsin 16244 Greenville5 Denis F. Faucher British Columbia 16257 Vancouver8 Juan Manuel M. Perez-Gutierrez Mexico West 16231 Jiquilpan, Michoacan8 Paul McCavick Kentucky 16232 Scottsville10 Leon Setera Montana 16228 Culbertson11 Robert T. Kikta Alabama 16248 Huntsville13 Dominic G. Orlando California 16255 Vacaville18 Stephen A. Rogers Virginia 16234 Sterling19 Jose I. Santos North Carolina 16247 Red Springs22 Robert W. Rasch Florida 16236 Orlando24 Henry Vitale New Jersey 525 Red Bank26 Nicholas Melanchok Massachusetts 16243 Winchester29 Thomas A. Reumont Maryland 16251 Valley Lee31 Henry A. Pilla, Jr. Massachusetts 16241 Waltham36 Wayne L. Lillie Ontario 16229 Oshawa56 William Walborn Pennsylvania 16240 Williamsport59 Lee Williams Illinois 16235 Peoria77 Jan Nowakowski Ontario 16233 Toronto77 Paul J. Sharum Pennsylvania 16238 Dudley87 Lizardo S. Versoza California 16256 Los Angeles

KNIGHTS OF COLUMBUS SAFE ENVIRONMENT PROGRAM

This section will be recurring monthly and contain frequently asked questions about the Knights ofColumbus Safe Environment Program.

What is the K of C Safe Environment Program?The Knights of Columbus Safe Environment Program is designed to protect young people served throughKnights of Columbus programs and activities, including the Columbian Squires Program, from all forms ofabuse. Councils participating in official Supreme Council programs and activities are required to complywith all policies and procedures of the Knights of Columbus Safe Environment Program. Knights ofColumbus Safe Environment Program requirements are in addition to all of the safe environment/youthprotection requirements established by local dioceses and parishes.

Who administers the Knights of Columbus Safe Environment Program? Who may I call with questions andconcerns about the Knights of Columbus Safe Environment Program?The Knights of Columbus Safe Environment Program is administered by the K of C Fraternal ServicesDepartment in partnership with Praesidium, an international leader in youth protection. All inquiries regardingthe program should be directed to the Knights of Columbus Safe Environment Program line at 203-800-4940 or youthleader@kofc.org.

FOR MORE INFORMATION VISIT KOFC.ORG OR CALL (203) 752-4473

NEW COUNCILS AND CIRCLES INSTITUTED LAST MONTH District DD Name Jurisdiction Council # Location99 T. (Skip) Langevin Ontario 16227 Caledon102 Joseph Zielinski Ontario 16254 Mississauga138 Jerry Kay California 16237 San Diegon/a n/a Connecticut 16253 New Haven (Ukrainian)B27 Mario W. Organo Luzon 16242 Bakun BeguetD02 Gil B. Baldorado Luzon 16249 Daet, Camarines NorteM47 Noel S. Lacanilao Luzon 16245 Baseco, Port Area, ManilaM84 Gabriel D. Muñasque Mindanao 16239 General Santos Cityn/a n/a Ukraine 16250 Kievn/a n/a Ukraine 16252 MelitopolN35 Manuel R. Cabungcal Luzon 16246 Batasan Hills, Quezon City

District DD Name Jurisdiction Circle # LocationC50 Felixberto Jampit Mindanao 5133 Gingoog CityC50 Felixberto Jampit Mindanao 5797 Gingoog CityD26 Guillermo Preglo Mindanao 5798 Digos, Davao del SurP45 Florencio Laparan Luzon 5796 Taguig