Colorado State Knights of Columbus - Icon Request Form - Knights of Columbus-St. John Paul II Council #17142

This form is to request the Sacred Heart of Jesus Icon to be displayed at your local parish or council hall. For more information and to order additional materials (booklets, prayer cards…) you may need for your event at you may need for your event at https://www.kofc.org/en/what-we-do/faith-in-action-programs/faith/pilgrim-icon.html You may also contact the State Faith Director – Smokey Mortus at 720-448-6433 or sjmortus@gmail.com

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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)?

Where will the Icon be displayed?

Church
Hall
Other (Note below)

Notes:

Please select any room amenities needed.

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

Please District Person

Additional notes or comments

Colorado State Knights of Columbus – Icon Request Form