Enrollment — TCHOU TCHOUMA TCHOUPITOULAS NATION

Tchou Tchouma Tchoupitoulas Application For Tribal Enrollment

1. Complete the entire application:

Print clear in black ink or use a typewriter.

2. Include with application:

Copy of Birth Certificate or Birth Card,
Birth and Death Certificate Forbears,
Bible Records, and other documents to prove lineage.

3. If applicant is the head of household or eighteen years or older, apply documents.

ALL INFORMATION REQUESTED TO PROVE LINEAGE OF ANCESTRY IS REQUIRED TO COMPLETE THIS TRIBAL ENROLLMENT PROCESS

Hopoksia Talako Luksi
Deputy Chief
hopoksiatalako19@gmail.com

Name

First Name

Last Name

Email Address

Subject

Message

Gender

Date of Birth

YYYY

Place of Birth

City, State, Country

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Has the applicant received and/or inherited any benefits in land or money by virtue?

Give name and relationship of a blood relative out of the tribe.

List there name and your relationship

In which area did applicants ancestors reside?

(County/Parish, State Republic)

Name of Applicant’s Spouse

If applicable

Indian Blood

If the above answer is yes what tribe?

Number of applicants children?

Applicant's Children Information

Name, Age, Sex, Date of Birth If not applicable please type N/A

Signature

Please type your full name to serve as your signature

First Name

Last Name

Date Signed

YYYY

Tchou Tchouma Tchoupitoulas Application For Tribal Enrollment

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