KofC State Icon Reservation - Knights of Columbus-St. John Paul II Council #17142

Name of Person Requesting

First

Last

This person will be responsible for arrangements to receive the Icon from another council and delivery of the Icon to it’s next council. This person will also be responsible for the care of the Icon and material.

Requestor's Email

Phone

Council Name

Council Number

District Number

Requested Date

End Date

Parish Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

How many people will be attending the meeting?

Is A/V required (projector, screen, virtual meeting abilities)?

Yes
No

Please note any special requests or needs that may be needed to make your presentation a success.

Where will the Icon be displayed?

Church
Hall
Other (Note below)

Notes:

Notes: displayed? a

Please select any room amenities needed.

Water
Water/Coffee/Tea
Notepad and Pen
Light snacks (fruit, vegetables, pastries)

Additional notes or comments