Kaniengehaga/Onkwehonwe Tsit-Kanaja First Nation
- PERSONAL INFORMATION PLEASE COMPLETE EACH SECTION
- First Name: _______________ Last Name: _______________ Middle Initial(s): _____
- Address: ______________________________________________________________
- City: _______________ Province: _______________ Postal Code: ________________
- Date of Birth dd: ____ mm: ____ yyyy: ______ Place of Birth:____________________
- Phone: ____________ Work: ____________ Cell: ____________ Fax: _____________
- Email Address: _______________________ Website: __________________________
- Gender: ______ M/F Height: ______ Weight: ______
- Marital Status Check: ___ Single: ___ Married: ___ Divorced: ___ Common-Law:
- Type of Membership: ____ Biological Descent: ____ Adopted: ____ Married In:
- Clan: ________ Wolf: ________ Turtle: ________ Bear: ________ Other:
- Tribe: ________________________________________________________________
- Are You Currently a Member of Another Aboriginal Band ? ___Yes: ___ No:
- If Yes Please Indicate What Band: _________________________________________
- ABORIGINAL ANCESTRY ANCESTRY INFORMATION
- _______________ Father: Aboriginal? ___ Yes: ___ No:
- _______________ Father's Mother: Aboriginal? ___ Yes: ___ No:
- _______________ Father's Father : Aboriginal? ___ Yes: ___ No:
- _______________ Mother: Aboriginal? ___ Yes: ___ No:
- _______________ Mother's Mother: Aboriginal? ___ Yes: ___ No:
- _______________ Mother's Father: Aboriginal? ___ Yes: ___ No:
- Please provide hard copies of your ancestral connection to our community. (Example) Birth, Marriage, Adoption and Death Certificates, Canadian Census or Indian and Northern Affairs documents and anything relevant.
- AFFIRMATION OF A SOLEMN OATH: I ____________________ hereby make application for membership with Tsit-Kanaja First Nation - A Kanien'gehaga/Onkwehonwe Band located in the Ottawa-Hull region of Canada. I understand that providing false statements or impersonating another individual within this application is considered a criminal act and will be punished to the fullest extent of the law. Should my application be accepted, I further agree to abide by the Traditional Laws of Tsit-Kanaja First Nation - A Kanien'gehaga/Onkwehonwe Band. I also understand that my membership may be revoked at anytime, should I fail to adhere to the guidelines set within this membership application.
- _______________ Signature of Applicant: _______________Witness: ________ Date: PLEASE COMPLETE THE ABOVE AND MAIL ALONG WITH ONE PASSPORT-STYLE OR PHOTO BOOTH PHOTO* TO: TSIT-KANAJA FIRST NATION: P.O.BOX 655, Winchester, Ontario, Canada, K0C-2K0.
- *NOTE: PLEASE DO NOT SEND PRINTED PHOTOS ON REGULAR PAPER. DO NOT SEND CROPPED, RETOUCHED OR OTHERWISE DIGITALLY ALTERED PHOTOS. SENDING PHOTOS OTHER THAN THE REQUESTED FORMAT WILL RESULT IN YOUR APPLICATION BEING DELAYED UNTIL THE APPROPRIATE TYPE OF PHOTO IS RECEIVED.
- I hereby authorize, give permission and appoint "Mr. Jason Gerald Edgar (Villeneuve) Arbour" to be the LEGAL REPRESENTATIVE and CHIEF of the Tsit-Kanaja First Nation, I am aware that Mr.Arbour will have all authority to negociate on our behalf. (TKFN) _______________ Signature: _______________ Witness: ________ Date: