Tel. 907.586.1432 www.ccthita-nsn.gov Toll Free 800.344.1432
Tlingit and Haida Indian Tribes of Alaska
Office of the President • Edward K. Thomas Building
9097 Glacier Highway • Juneau, Alaska 99801
Verification and Release of Information
I certify that the information provided in this application is true and correct to the best of my
knowledge and ability. I understand that any misrepresentation or any concealment of
information will be sufficient for rejection of this application or removal from Youth
Commission position.
I agree to abide by the Terms and Conditions (enclosed with this application) of the Tlingit &
Haida Youth Commission Position, and I understand that failure to comply may result in the
removal from the advisory position.
I authorize the release of my name, community, school, major field of study or program,
graduation and special honors, for use by Tlingit & Haida for educational and/or public relations
use.
Signature of Application Date
Signature of Parent/Guardian (Applicants Under 18) Date
Signature of Tlingit & Haida Community Council President Date
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