NICOA Member Online Application


We are glad that you have chosen to become a member of the National Indian Council on Aging (NICOA). Please fill out the application form and we will contact you if we have any questions about your membership application. 

Membership Form 2023-2024 (effective January 1, 2023 through December 31, 2024)

Select an Option: Choose the type of member you qualify for:

Check the box next to the type of member you are, Voting Member or an Associate Member 

Fill out your personal information. We will not share this with anyone. It is just for our records.  

First name, Last name and email, click next

Fill in your personal address, city, state, zip code, and phone number. 

Voting Members: Choose the name of your tribe from the drop-down menu, or start typing it and the system will fill it in automatically. Keep in mind these are the federally recognized names; you will need to provide your CIB number (Certificate of Indian Blood, or Tribal Identification Number). These are required fields.

If you are from an Alaska tribe, choose Other and type in the tribe name.

Billing Details: Please type in the information that is associated with the credit card you are using to pay for membership.

Check Box: Leaving the box checked will allow you to set up automatic payments for membership dues on January 1 of the next membership cycle. 

If you have any questions, or need assistance, please email Cheryl Archibald or call (505) 292-2001, ext. 1900.

Select An Option

any person not eligible to be a voting member

A qualified voting member is “any Indian 55 years of age or older who is an enrolled member of an Indian Tribe, Band, or Combination of Bands and Tribes, recognized by the United States Department of the Interior”.  PLEASE ATTACH A COPY OF PROOF OF TRIBAL ENROLLMENT OR CIB CARD.  IF YOUR CIB CARD IS NOT AVAILABLE-YOU MUST HAVE YOUR TRIBE’S AUTHORIZED ENROLLMENT OFFICIAL ATTEST TO THE FOLLOWING.  
Enter Contact Information
Please select a valid membership option and fee item if exist