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 2020-2021 (effective January 1, 2020 through December 31, 2022)
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 Associate Member (if you are an organization member please let us know if you are also a Voting or 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.