Membership in the Kitpu First Nation Mi'kmaq Community
Kitpu First Nation Membership Application:
Your Full Name: _________________________________
Your Date of Birth:______________ Your
Place of Birth:______________
Your Present Address:_______________________________
____________________________________________________
Prov:
____________
Postal Code:______
Telephone No.: (____ )_______________
Email Address:_________________________
Mi'kmaq
ancestry is claimed from: _______________________________________
__I am transferring from another band. Name of band:
___________________
__I am not transferring from another band.
My family Member already in the Kitpu First Nation
Band (if known):
Name:_____________________Relationship to you:____________Member #:___________
My child/children
under 19 applying with me:
_____________________________________________________
I am a resident of the Province
of Newfoundland & Labrador
Yes___ No___, If no, Province of ____
SIN. #: _________________ Occupation
(optional): ____________
Certification:
I hereby certify that the above
information is true and correct. I further certify
that I am not a member of any other aboriginal band.
Applicant
signature:________________________________Date: ____________
Additional Information: ______________________________________________
Approved
on: ________ Signed by Secretary: _______________________
Please mail to: Applications, 69 Colonial Ave Stephenville
NL A2N 1Y9
A self-addressed-stamped-envelope is required to send your acceptance letter.
2005 © Kitpu First
Nation
