Southern Ute Royalty Request Form
Southern Ute Royalty Committee
Southern Ute Indian Tribe
P.O. Box 737, MS #8, Ignacio, CO 81137
(970) 563-0100 ext. 2984 Fax (970) 563-1098
The Southern Ute Royalty Committee recommends that all inviting Organizations, and/or Departments submit the form at
least two weeks in advance of your Event to allow time for review and scheduling. Please submit your request to the
Royalty Committee tribal mail box #88, e-mail (ebbox@southernute-nsn.gov
) or deliver to the Culture Department, located
on the second floor of the Southern Ute Museum, 77 C.R. 517, Ignacio, CO 81137. Your request will be reviewed by the
Southern Ute Royalty Committee at their next scheduled meeting. Please include your Program/Event Schedule, Booklet,
Flyer, or any information pertaining to the Event.
Last minute invites may be considered pending the availability of our Royalty at the time of your request.
Name of Event: __________________________________________________________________________
Date(s) of Event: _______________________________ Time of Event: _______________________
Location of Event: ___________________________________________________________________
Role in Event: _____Introduction/Welcome Address _____Parade _____Lord's Prayer _____ Dance Performance
Royalty Requested:
_____ Miss Southern Ute _____ Miss Southern Ute Alternate
_____ Junior Miss Southern Ute _____ Junior Miss Southern Ute Alternate
_____ Little Miss Southern Ute _____ Little Southern Ute Alternate
_____ Southern Ute Brave _____ Southern Ute Brave Alternate
_____ All Southern Ute Royalty
Travel Required: Yes No
Lodging: Yes No Hotel/Motel Location: ______________________________________
______________________________________
Meal Provided: Yes No
Main Contact Information:
Name: ___________________________________________
Organization: ___________________________________________
Address: ___________________________________________
Phone No: ___________________________________________
Location: _____________________ Fax No: ______________
Accepted Denied Attendees: MSU MSUA JMSU JMSUA
LMSU LMSUA SUB SUBA
Southern Ute Royalty Committee, PO Box 737 - MS#88, Ignacio, CO 81137
970-562-0100, Ext. 2984 Fax No: 970-563-1098
