ICWA Committee Application
This is a voluntary 5-year position to be a member of the Native Village of Eyak Indian Child Welfare Act Committee. The
committee will meet once a month to discuss Alaska Native Children that are in the OCS system. Once a month you will
meet with the ICWA coordinator to go over cases that the Tribal council have intervened upon and any future cases that
the tribe is notified of Children who have entered the OCS system. The committee will hear the details of cases, be made
aware of all possible interventions on families and placement of children. The committee will also serve on the Child
Advocate program that handles child abuse, child neglect, and sexual assaults. Members must be able to listen to and
discuss sensitive details of case.
Telephone: Social Security Number Mailing Address:
Are you known by any other name?
Are you Alaska Native? Do you have a C.I.B?
If yes tribe of origin:
Are you a legally eligible for employment in the United States: Have you ever been
convicted of a felony?
If yes, identify the date of conviction, where the charges were determined, the
nature of the charge and case number.
Have you ever been convicted of a misdemeanor involving violence, minors under the
age of 18 or weapons?