Fourth Degree emblem
Knights of Columbus · Supreme Form 4

Fourth Degree Membership Document

Fill in on screen, download the PDF, print and sign
‹ Chalice program & forms

Fill in what applies to you and press Create my Form 4. You get the official Supreme PDF with your answers typed in, ready to print and sign.

Nothing leaves this device until you choose Send it to the assembly at the end. Prefer paper? Download the blank form.

See what your finished Form 4 will look like A sample Form 4 filled in for a made-up Sir Knight, Joseph Example: name, address, phone, date of birth, council 799, parish, assembly 1087 and proposer number typed into the boxes, with New Member ticked

A made-up example. Signatures, the Financial Secretary’s certification and the officers’ sections stay blank for ink.

6What is this form for?

1About you

Pick from the list or type it.

2Citizenship

3Previously a Fourth Degree member?

Only for restorations and anyone who was a Sir Knight before. Otherwise skip this.

Yes, I was initiated into the Fourth Degree before

4Parish & assembly

Supreme requires it. The Sir Knight who proposed you; ask him or any officer.
Download again

Send it to the assembly

We’ll check it over and help with the next steps. You still sign the printed copy.

  • Check it, then print it. You can still correct it in any PDF reader.
  • Sign and date it in Section 4, and have your proposer sign beside you.
  • Give it to your council’s Financial Secretary to certify Section 7.
  • Then hand it to the Faithful Comptroller, or mail it to the assembly at 10228 E. Northwest Hwy., Box 101, Dallas, TX 75238.