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: Kitpu First Nation 332 Site 1 RR 1 Aguathuna NL A0N 1A0 A self-addressed-stamped-envelope
is required to send your acceptance letter.
2005 © Kitpu First Nation
