Nominate a Candidate for 4th Degree Hall of Fame

Name of Nominee*
First Middle Initial Last
Wife's Name
3rd Degree Initiation Date*
MM slash DD slash YYYY
Council Number*
Council Name*
Council Location*
4th Degree Initiation Date*
MM slash DD slash YYYY
Assembly Name*
Assembly Location*
OFFICER POSITIONS HELD IN THE THIRD DEGREE
Officer Position Council Dates

Add as many lines as needed by clicking on the + sign at the end of the row
OFFICER POSITIONS HELD IN THE FOURTH DEGREE
Officer Position Assembly Dates

Add as many lines as needed by clicking on the + sign at the end of the row
Accomplishments
The narrative should include any and all accomplishments, which can help the Sir Knight qualify for the Hall of Fame Award. These can include projects or activities which he initiated, above and beyond his normal duties as a Sir Knight. Be sure to organize the information into the categories listed - Good of the Order, Community, Church, and Country. Be as explicit, factual, and accurate as possible.
Good of the Order*
Community*
Church*
Country*
We, the undersigned, certify that all information contained herein is true and correct*
Name Position Date

Three Sir Knights from the nominee's Assembly must sign this report (use the + sign to add rows)

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Officer Position	Council	Dates

Officer Position	Assembly	Dates

Name	Position	Date

Accomplishments