| Membership Information |
| If you are a descended from one of the 26 Delaware who remained in Kansas in 1866, you are probably a Kansas Delaware. A few Delaware went on to Oklahoma after the major migration and became Cherokee-Delaware in 1906. |
| Mail application to: Bob Deister, Rolls & Membership P.O. BOX 597, Buhler, Kansas 67522; KansasDelawareRolls@aol.com |
________________________________________________________________________________________________________ LAST NAME FIRST MIDDLE MAIDEN DATE OF BIRTH ______________________ ____MALE ____FEMALE ________________________________________________________________________________________________________ MAILING ADDRESS(NUMBER, STREET, ROUTE, BOX) CITY STATE ZIP PHONE NUMBER (____)___________________________ E-MAIL ____________________________________ Are you a member of any other Tribe? _____ NO ____ Yes Tribe____________________ Is applicant adopted? _____ NO _____ Yes Ancestor on 1867 Roll ___________________________________________________________ (List your Descendence below) |
| APPLICATION FOR MEMBERSHIP (PLEASE PRINT IN INK) |
| ALL INFORMATION WILL REMAIN CONFIDENTIAL A copy of birth record must be submitted with application |
| CHANGE OF ADDRESS NOTICE |
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_________________________________________________________________________ YOUR NAME OLD MAILING ADDRESS______________________________________________________________________________ NEW MAILING ADDRESS ______________________________________________________________________________ PHONE NUMBER (____)_________________________________ _______________________________ DATE OF ADDRESS IN EFFECT SIGNATURE _______________________________________________ MAIL TO: Bob Deister, ROLLS & MEMBERSHIP, P.O. BOX 597, Buhler, Kansas 67522 |