MEMBERSHIP APPLICATION
Tuolumne Band of Cherokee Indians,
Beneficial Society Reg. No. 7696
P. O. Box 612
Twain Harte, CA 95383
http://www.tuolumnecherokees.com
Name: ___________________________________________________________
Date of Birth: ______________________________________________________
Mailing Address: ____________________________________________________
Street Address: _____________________________________________________
Telephone No: ______________________FAX No: _________________________
E-Mail Address: _____________________________________________________
There is only one class of membership: Life Membership: Life Membership, for
Individuals over 18 Years of age.
Donations of: $30.00, payable either in one lump sum, or in $5.00 increments. Tax
Deductible Donation Tax exempt I. D. #30-0472269.
I would like to pay: for membership this way:
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I would simply like to donate:
__________________________________________________________________________
Please list any skills or knowledge that you may have, and would like to contribute, (arts,
Crafts or otherwise) that would serve to strengthen and add to the success of
The Tuolumne Band of Cherokee Indians, Inc.
___________________________________________________________________________
___________________________________________________________________________
Applicant Signature And Date:
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