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NAIEA |
FOR OFFICE USE ONLY:
NAIEA Number ____________
Date of issue ______________ |
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National American Indian
Enrollment Agency
William LameBull, Director 
Web address www.naiea.com
P.O. Box 1900, Grants, NM 87020
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Individual Application Form
International Registry of Federally Recognized & Non-status American
Indians
TYPE or PRINT
NAME _____________________________________________________
(Last
Name,
First
Name,
Middle Initial)
DATE OF BIRTH _______________ TELEPHONE _________________
MAILING ADDRESS _________________________________________ |
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Ancestral Affiliation (Example: Sioux, Chippewa,
Etc.)
Indicate below what you know of your Native American ancestry. (If
more space is required attach additional sheets.)
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THIS FORM MAY BE
COPIED FOR USE
BY ADDITIONAL
APPLICANTS
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I swear that the information I am providing is true and correct to the best
of my knowledge:
Signature of applicant: ________________________________
Date ___________
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NOTE!:
We must have a professional quality, color
I.D. photo
(PASSPORT type photo, PLEASE!) to properly process your
application.
ALLOW 6 TO 8 WEEKS FOR RECEIPT OF NAIEA CARD.
INDIVIDUAL
ENROLLMENT FEE OF $25.00 MUST
ACCOMPANY APPLICATION
Make MONEY
ORDER payable to LAMEBULL...
PERSONAL CHECKS NOT ACCEPTED. |
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Incomplete/incorrect applications and/or money orders will result
in delay of issuance of enrollment number and ID card. Duplicate cards will be issued for a fee of $5.00 (additional
photo required).
Enrollment records will remain on file with
NAIEA until an individual personally requests deletion of his/her
records and filing with this agency.
| NAIEA IS NOT a Government Agency. NAIEA
neither offers nor suggests any benefit with enrollment,
beyond a manner by which individuals may display their
Native American Heritage through possession of the coveted,
NAIEA photo I.D. Card, and enrollment in a legitimate
enrollment agency, as well as tribal membership in the
National Confederacy of Native American Peoples. |
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