Fr. Marcel Salinas Council #11536 Interest Form

1730 West Guadalupe Road • Mesa, Arizona 85202

Membership Interest Form

Thank you for your interest in joining Knights of Columbus Fr. Marcel Salinas Council. Please fill out the interest form with as much information as you wish to share about yourself. The form will be emailed to our Membership Chair, John Nekoranec. He will be contacting you within a few days of your submission.

General Information

* Name:
* Address:
* City:
* State:
* Zip Code:
* Home Phone:
Work Phone:
Cell Phone:
Email address:
Date of Birth:
Place of Birth:
Marital Status:	Married Single Widower Divorced
If married, wife's name:
Number of children:	Boys Girls
Occupation:
Employer:
Parish:
Hobbies:

Program Involvement

Please let us know what programs you would like to be involved in:

Church		Community		Council
	Vocations		Pro Life		Public Relations
	Parochial Services		Health Services		Fraternalism
	Religious Devotion		Civic Involvement		Blood Donors
	Lay Apostolate		Decency		Social
	Christ in Christmas		Human Needs		Athletics
			Public Safety		Cultural Events

Family		Youth		Membership
	Survivor's Assistance		Scouts		Recruitment
	Family of the Month/Year		Youth Groups		Retention
	Memorials		Educational Programs		Insurance Promotion
	Education		Athletics		Admissions Committee
	Communications		Religious Activities		Ceremonials
	Recreation		Social Activities

What do you personally expect from your membership in the Knight of Columbus?

Membership in the Knights of Columbus is open to practicing Catholic men in union with the Holy See, who are at least 18 years old. A practicing Catholic is one who lives up to the Commandments of God and the precepts of the Church. By submitting this interest form, you attest that you meet the requirements to join.

* Required information

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