| Annual Survey of Fraternal Activity | |
| Number of Meetings Held During Year: | |
| Regular | |
| Social | |
| Special | |
| Total | |
| Activity Expense | |
| Printing and Postage | |
| Food and Refreshments | |
| Prizes | |
| Projects | |
| Entertainment | |
| Miscellaneous | |
| Total | __________ |
| Charitable Disbursements | |
| Church Activities | |
| Church Facilities | |
| Catholic Schools | |
| Religious Education | |
| Seminarians / RSVP | |
| Seminaries | |
| Vocations Projects | |
| Miscellaneous | |
| Total | |
| Community Activities | |
| Elderly | |
| Physically Disabled | |
| Special Olympics | |
| Intellectual Disabilities | |
| Human Needs | |
| Pro-Life Programs | |
| Victims of Disasters | |
| Hospitals / Institutions | |
| Health and Service Organizations | |
| Community-wide Projects | |
| Habitat for Humanity | |
| Miscellaneous | |
| Total | |
| Youth Activities | |
| Columbian Squires | |
| Scouting | |
| Youth Groups | |
| Youth Welfare / Services | |
| Athletics | |
| Scholarships / Education | |
| Miscellaneous | |
| Total | |
| Total (Church / Community / Youth) | |
| Fraternal Committment | |
| Number of visits to Sick | |
| Number of visits to Bereaved | |
| Total Visits | |
| Number of blood donors | |
| Habitat for Humanity | |
| Estimated hours of volunteer service | |
| Church | |
| Community | |
| Youth | |
| Habitat for Humanity | |
| Miscellaneous | |
| Total Volunteer Hours | |
| Estimated hours of Fraternal Service | |
| Sick / disabled members and their families | |