OFFICE OF TRIBAL ENROLLMENT Tribal enrollment is one of the most significant elements in your life. Unfortunately, tribal enrollment can be as complex...
OFFICE OF TRIBAL ENROLLMENT Tribal enrollment is one of the most significant elements in your life. Unfortunately, tribal enrollment can be as complex and confusing, as it is important. Membership into Thlopthlocco Tribal Town allows you to continue your shared past into a shared future. The first priorty for eligibility is that a matrilineal descendancy from a base enrollee of the 1890 Creek Census Roll or 1895 Creek Payroll of the Thlopthocco Tribal Town exists. The second, if the biological mother has no Muscogee (Creek) blood whatsoever, and the father is a tribal member then the applicant is eligible for membership. Wayne Harjo, Enrollment Manager Wendy Wind, Enrollment Clerk PHONE: (918) 560-6107
FAX: (918) 623-3023
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THLOPTHLOCCO TRIBAL TOWN
OFFICE OF TRIBAL ENROLLMENT
P.O. BOX 188
OKEMAH, OK 74859
(866) 988-8696 ext. 107 (Toll Free)
FAX 918-560-6195
APPLICANT
In order to complete, review/research your f:tIe for membership into the ThlopthJocco
Tribal Town, you will need to provide copies of the following supporting documents.
WE DO NOT ACCEPT INCOMPLETE APPLICATIONS. INCOMPLETE
APPLICATIONS WILL BE RETURNED.
__ Application for Enrollment
__ Family Tree (Please use maiden names and indicate ifnon-Creek or non-Indian where applicable.)
State Issued BirtblDeath Certificates of all Lineal Descendents of Base EnroUee __ Signed Release of Information (eDlB 8110 document) __ Muscogee (Creek) Nation Citizenship Card/CDlB card _
Social Security Card
__ A Final Decree of Adoption (ifapplicabJe) Creek Enrollment Census Card and RoB Number of Base Enrollee
If you have any question, please feel free to call the Enrollment Office.
(FORM £-01)
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THLOPTHLOCCO TRIBAL TOWN OF OKLAHOMA APPllCAnONFORNrnMB~HW
Last Name
FlISt
Maiden Name
Cuneot Maiting and Physical Address Zip Code
(Area Code)
HomeICeII Number
(Area Code)
Other Contact #
Sex of AppIic3llt DaleofBinh._ _~~_ _ _ __
Place of Birth
~---------------
Base Enrolles through wbom Membership tights ala claimed:. . Full Name
Roll Number
Is the appbnt an enrolled member of the Muscogee (Creek) NaIion1_Yes
Is the apl*mt a member of anothertlibe other than Musoogee (Creek) Nation?
Is the applicant an adopted child? Name(s) of applicant's Chikl(ren)
BroIher(s)
SisIer(s)
By signing below, I certify that the information contained in this appflCation is true and correct to the best of my knowledge, and that false or misleading information can result in 1he denial of my application for membership. Furthermore, I understand that lie completion of this appIiCatlondoes not guarantee my enrollment as a member of the ThIopthlocro Tribal Town.
APPLICANT'S SIGNATURE OR DESIGNEE (IF MINOR. INCOMPETENl)
DATE
FOR OFFICE USE ONLY DATE APPLICATION RECEIVED_ _ _ _ _ _ _ _ _ _..-:APPUCATION NO.'---_ _ __ RECEIVED BY:_ _ _ _ _ __
THLOPTHLOCCO TRIBAL TOWN TRIBAL ENROLLMENT OFFICE PO BOX 188 O~ OK. 74859 866-988-8696 ext. 107 FAX (911) ~3023
I, , hereby authorize the release of my CERTIFIED DEGREE OF INDIAN BLOOD (IXIO) document to Thlopthlocco Tribal Enrollment Office. I undentaDd this eoufideatial documeat ooataiDs penoul iafo......tioa aad also my aaeestral liDeage. This copy is for my penoaal file aDd DO additioaal oopies are to be released without my written consent.
