OF COLUMBUS LA. STATE COUNCIL Catholic Youth Leadership Nomination Form 2021-2022

Nominating Council Please check the proper category ______Sr. Male Division ______Sr. Female Division

STUDENT INFORMATION

NAME: ______DATE OF BIRTH: ______

ADDRESS: ______

CITY: ______ZIP CODE: ______PHONE: ______

E-MAIL ADDRESS: ______

FATHER’S NAME: ______MOTHER’S: ______

CHURCH PARISH: ______

HIGH SCHOOL: ______

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * RULES AND INSTRUCTIONS – PLEASE READ CAREFULLY 1. Only High School Seniors who are Practical Catholics are eligible. 2. If one or both parents are deceased, please indicate name of guardian or foster parent(s). 3. Every information area must be answered. Use the space provided on this form first and, if space is insufficient, you may attach an additional sheet or sheets. (We recommend that you use 12-point font, on additional sheets) 4. Information to be entered on the form should be from the nominee’s Junior and Senior years only. 5. Nomination form must be signed by the nominee’s Principal or High School Counselor, Pastor or Associate Pastor and the Grand of the Council submitting the nomination. 6. IT IS PREFERABLE THAT YOU USE THE ONLINE INTERACTIVE FORM FOUN at https://www.louisianakc.org/programs/cyla/ . Click on the word “Application” to open the latest version of the CYLA application. Once you completed all sections, print a hard copy of the form. You should be able to save the form in your computer. LEGIBILITY IS VERY IMPORTANT. 7. EACH STUDENT MUST SUBMITE THE ORGINAL FORMS TO THEIR COUNCILS-With All Required Signatures on Page 6 Completed. 8. All forms must be mailed, or hand delivered, no email version will be accepted.

1 CYLA SUGGESTIONS

We have listed some suggestions for each one of the sections of our CYLA form, although there many more organizations and activities that the student may be involved in other than what is being listed on this page. We hope this information will help our CYLA participations to fill out a complete and strong CYLA Application.

Church Related Spiritual Activities- Usher, Eucharist Minister, Church Choir, Children Liturgy, Parish Religion, Parish Mission, Parish’s Adoration Chapel, Youth Rally or Conferences, Vacation Bible School, Steubenville South, Youth Retreat, Abbey Youth Fest, Pro- Life Events and Rallies, Peer Ministry, World Youth Day, Way of the Cross, St Vincent DePaul, Church Fair, Life Teen Parish Youth Group, CYO, Mission Trips, Catholic Daughters and Knights of Columbus.

School or Other Spiritual Activities- School Mass Liturgies- (Lector, Eucharist Minister, Usher, Altar Server, School Mass Choir, School Liturgy Committee), School Retreats, School Bible Study Group, Campus Ministry, Christian Athletics, School Adoration, School or Community Prayer Services, March for Life, Family Bible or Prayer Group, School Prayer Group, Community Religious Services.

Scholastic Activities-Student Council, National , Art Club, Yearbook Staff, 4-H, FFA, Beta Club, Spanish Club, Drama Club, Boys State, Girls State, Jr. ROTC, Band, School Ambassador, Band Honors, Class Officer, School or Honors.

Community Activities- Boys Scout, Girls Scout, 4-H, Beta, Soup Kitchen Volunteer, Homeless Shelter, Charitable Events, Special Olympics. Blood Donor, Habitat for Humanity, Nursing Home Volunteer, Community Award or Honor, Knights of Columbus Events, Knights of Columbus Essay Contest.

Athletic Activities- School Athletic Teams (Football, Baseball, Basketball, Track, Bowling, and any other Sporting Team), Cheerleader, School Dance Team, Recreational Bowling, or any other Recreational Sporting.

School Based Social Activities- School Plays, Jr/ Sr. Prom, School Dances, Homecoming Court, Open House, School Trips, School Field, Career Day, Athletic Banquets, Ceremony, Winter Formal, School Club Conventions. College Day or Visits. School Pageant, Cheerleading Camp,

Non School Social Activities- Christmas Parade, Mardi Gras Parade, Parade Participant, Veteran Day Events or Parade, Community Fair or Festival, Youth Lock In, Community torus, Family Reunions, Family Picnic, Sporting Pick Up Games, Athletic Camp Participation, Camp Counselor, . Fourth of July Events, Halloween Party or Carnival.

Do Not Submit This Page

I. SPIRITUAL ACTIVITY A. CHURCH PARISH ACTIVITY: Describe participation in spiritual life of the Church Parish, such as Altar Server, Lector, Eucharistic Minister, Usher, Choir, Columbian Squires, Knights of Columbus, Catholic Daughters, Squirettes, etc. Give length of service and office held. Junior Year ORGANIZATION OFFICE HELD AWARDS/ HONORS ______

Senior Year ORGANIZATION OFFICE HELD AWARDS/ HONORS ______

B. OTHER SPIRITUAL ACTIVITES: School - related ministries, special Events, retreats attended, bible school, etc. Junior Year ORGANIZATION OFFICE HELD AWARDS/ HONORS ______

Senior Year ORGANIZATION OFFICE HELD AWARDS/ HONORS ______

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II. SCHOLASTIC ACHIEVEMENT A. Please list grade point average for nominee as a: Junior: ____ Senior: ____ B. List scholastic groups or honors awarded and any office held, such as Honor Society, BETA Club, Band, Debate Team, Year Book Staff, Awards, etc. Junior Year ORGANIZATION OFFICE HELD AWARDS/HONORS ______

Senior Year ORGANIZATION OFFICE HELD AWARDS/HONORS ______

III. CIVIC-COMMUNITY/CULTURAL ORGANIZATIONS List organizations and service related clubs, honors, awards, and offices that you have held. Junior Year ORGANIZATION OFFICE HELD AWARDS/HONORS ______

Senior Year ORGANIZATION OFFICE HELD AWARDS/ HONORS ______

3 IV. ATHLETIC ACTIVITY

Junior Year ACTIVITY ELECTED POSITION AWARDS/ HONORS ______

Senior Year ACTIVITY ELECTED POSITION AWARDS/ HONORS ______

We are Knights of Columbus.

Formed in 1882, the Knights of Columbus is the world’s largest Catholic fraternal organization.

Membership is open to practical Catholic men who are 18 years old or older.

Knights support and serve the Church, their community, their family, the youth and those in need. We are men of faith and men of action.

Knights (and family of knights) also receive exclusive access to certain college scholarships and exclusive access to top rated life insurance and retirement products.

Become a Knight. Support the Knights.

Websites: www.KofC.org www.louisianakc.org

Email: [email protected]

4 V. SOCIAL ACTIVITY A. SCHOOL BASED ACTIVITIES Junior Year ORGANIZATION ACTIVITY AWARDS/HONORS/OFFICE ______

Senior Year ORGANIZATION ACTIVITY AWARDS/HONORS/OFFICE ______

V. SOCIAL ACTIVITY B. SOCIAL ACTIVITIES NON-SCHOOL RELATED Junior Year ORGANIZATION ACTIVITY AWARDS/HONORS/OFFICE ______

Senior Year ORGANIZATION ACTIVITY AWARDS/HONORS/OFFICE ______

5 VI. GENERAL INFORMATION A. Please indicate nominee plans after high school graduation, college planning to attend, subject major, as well as any other present plans.

REQUIRED SIGNATURES: My signature below states that I have been truthful completed this application.

______STUDENT SIGNATURE DATE

______Student’s Church Parish Signature of Pastor or Associate Pastor

______Signature of Grand Knight of Nominating Council Signature of School Principal or Counselor

______Nominated by Council # : ______Nominating Council’s Church Parish

______Signature of Grand Knight of Council Serving the Student’s Church Parish (if different from nominating Council’s church parish) Council Number : ______

(Send to DIOCESAN ADMINISTRATOR) Before mailing this nomination form, please check the following items: 1. Review entire form to see that ALL sections are completed. 2. Make sure that all required signatures are on nomination form. 3. Make sure the nominating KC Council Number is listed on the form. 4. BE SURE THAT ALL PAGES ARE INCLUDED.

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