Direct: (918) 458-6980 Fax: (918) 458-7617 Dawes Application
Applicant’s Full Legal Name:
Applicant’s Address (including zip code)
Applicant’s signature (Under age 18, parent or legal guardian signature
) Date
Physical:
Applicant’s Maiden Name (when applicable):
Mailing:
Applicant’s Date of Birth:
Applicant’s Place of Birth:
Is Applicant Adopted?
Yes No
Are Applicant’s Parents Adopted?
Yes No
If Yes, list natural (birth) parents
If known:
Instructions:
Trace back ONLY through the
ancestor with the Dawes roll
number.
Applications submitted without
a Dawes roll number will be
returned.
Include applicant’s original, state
certified birth certificate. If no one
in the family has applied, please
return with original, state certified
birth and death certificates linking
the applicant to the Dawes enrollee.
If an immediate family member has
already applied or received a card,
please list their name and date of
birth below:
PROCESSING TIMES VARY
Father’s Name:
Roll No:
DOB:
Deceased: Yes No
Year:
Paternal Grandfather’s Name:
Roll No:
DOB:
Deceased?/Year:
Paternal Great Grandfather’s Name:
Roll No:
DOB: Deceased?/Year:
Paternal Great Grandmother’s Name:
Roll No:
DOB: Deceased?/Year:
Paternal Grandmother’s Name:
Roll No:
DOB:
Deceased?/Year:
Paternal Great Grandfather’s Name:
Roll No:
DOB: Deceased?/Year:
Paternal Great Grandmother’s Name:
Roll No:
DOB: Deceased?/Year:
Mother’s Name:
Roll No:
DOB:
Deceased: Yes No
Year:
Maternal Grandfather’s Name:
Roll No:
DOB:
Deceased?/Year:
Maternal Great Grandfather’s Name:
Roll No:
DOB: Deceased?/Year:
Maternal Great Grandmother’s Name:
Roll No:
DOB: Deceased?/Year:
I certify that the information which I
have provided with this request to
Cherokee Nation is true and correct.
Revised 09/22/2017
Maternal Grandmother’s Name:
Roll No:
DOB:
Deceased?/Year:
Maternal Great Grandfather’s Name:
Roll No:
DOB: Deceased?/Year:
Maternal Great Grandmother’s Name:
Roll No:
DOB: Deceased?/Year:
SUBMIT TO: CHEROKEE NATION TRIBAL REGISTRATION, PO BOX 948, TAHLEQUAH, OK 74465
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___________________ _________________________________________________________
LASTNAME FIRSTNAME MIDDLENAME MAIDENNAME
DATEOFBIRTH____________ ___ MALE FEMALE __________________________
MO.DAYYEARSOCIALSECURITYNUMBER
______________________________________________________________________________
PHYSICALADDRESS(Required)CITY STATE ZIP
_______________________________________________________________________________
MAILINGADDRESSCITY STATE ZIP
___________________________
PRIMARYPHONENUMBER
HaveyouregisteredasacitizenoftheCherokeeNationbefore? YES NO
When?______________________________Registrationnumber ? _____________________________
Theperson whosigns theapplication isrequired toencloseacopy ofhis/herStateID orState
Driver’sLicense.
Parentsmustsignforapplicant(s)under18.
Otherpersonmaysignforminorordisablediflegal
documentationissubmitted.
___________________________________________________________________________________
SIGNATUREOFAPPLICANT(Requiredinink) DATEOFSIGNATURE
BY SIGNING THIS APPLICATION FOR CITIZENSHIP, I VERIFY ALL INFORM ATION PROVIDED IS TRUE AND CORRECT. UNDER CHEROKEE NATION
CODEANNOTATEDTITLE11,CHAPTER2,SEC11.B:Anapplicantorsponsorwhoknowinglyfilesfalseorfraudulentinformationwillberejected
forenrollmentandmaybesubjecttocriminalprosecution.
_________________________________DONOTWRITEBELOWTHISLINE_________________________________
APPROVED DISAPPROVED
REASON:_____________________________________________________________________________________
_____________________________________________________________________________________

_______________________ _______
UPDATED(05/18)
 REGISTRAR DATE
CHEROKEENATION
RegistrationDepartment
P.O.Box948
Tahlequah,OK744650948
9184586980
APPLICATIONFORCITIZENSHIP
INTHECHEROKEENATION
(PRINTINBLACK/BLUEINK)
ORIGINALMUSTBEMAILED
CHEROKEEREGISTRYNUMBER
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