203 Survey of Fraternal Activity

Please provide the information requested below. You can print this page and fax it to Ray Marr, 704-947-8990, or e-mail the information to raymarr@bellsouth.net.
Last year, the Knights of Columbus donated more than $125.6 million to charitable and benevolant causes and 58.9 million hours of volunteer community service to aid the less fortunate. To help prepare our Fraternal Survey for the Supreme Council office, the information requested below are needed. This information will assist us in determining the total number of hours of community service volunteered by our members during 2004.

Knight's Name: _______________________

1. Number of visits you made during 2004 to:
Sick - caring for the sick / nursing homes / hospitals	________
Bereaved - visits of condolence	________
2. Number of times you served as a blood donor during 2004	________
3. Estimated hours of community volunteer service during 2004:
Church Activities - service in all Church related activities	________
Community Activities - service in all community related activities	________
Youth Activities - service in all youth related activities	________
Miscellaneous Activities - service in areas not outlined above	________
4. Number of hours of fraternal service during 2004:
Sick/disabled members and their families - household chores,
transportation, tutoring, counselling, etc	________