<p>Father Diamond Council Personal Information Update Form</p><p>Update your personal information now. Just fill out the form and either mail or e-mail to:</p><p>Larry Gottschalk Financial Secretary C/O Knights of Columbus Council #6929 3702 Old Lee Highway Fairfax, Va. 22030 e-mail: [email protected]</p><p>Title (if any): ______Degrees (1-4): ______</p><p>Name (First, MI, Last): ______</p><p>Social Security No.: ______Telephone No. (___) ______</p><p>Date of Birth: ______Current Parish: ______</p><p>Current Address</p><p>Street Address: ______</p><p>City: ______State: ______Zip Code: ______</p><p>E-Mail Address: ______</p><p>Marital Status (S/M/W): ______Date Married (M/D/Y): ______</p><p>Spouse’s Name (First, MI, Last): ______</p><p>Next of Kin</p><p>Name (First, MI, Last): ______</p><p>Relationship: ______</p><p>Telephone No.: (___) ______</p><p>Street Address: ______</p><p>City: ______State: ______Zip Code: ______</p><p>The form can be found on the Council Website: http://www.6292.kofcva.org </p>