We are glad that you have chosen to become a member of NICOA. Please fill out the application form to the best of your ability and we will contact you if we have any questions about your membership application.
Membership Form 2016-2018 (effective October 1, 2016 thru September 30, 2018)
Select an Option: Choose the type of member you qualify for:
Check the box next to the type of member you are, Voting, Associate, or Organization (if you are an organization member please let us know if you are a Voting or Associate member. This allows for two people from the organization, each must fill out a separate form.)
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. (we use email because it is a lot cheaper than regular mail and you can receive information faster. We will not send you junk mail)
Fill in your personal address, city, state, zip code, and phone number.
Voting Members: if you are a voting member choose the name of your tribe from the drop down menu, or start typing it in and it will auto fill, 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
Billing Details: Please type in the information that is associated with the Credit Card you are using to pay the membership with.
Check Box: Leaving the box checked will allow you to set up automatic payments for Membership Dues on October 1 of the next Membership Cycle.
If you have any questions, or need assistance, please contact Cheryl Archibald at firstname.lastname@example.org or call (505) 292-2001, ext. 1900