2025 Membership FormThe membership form is now closed, and no further health and wellness funds or benefits will be issued for 2025. Name * First Name Last Name Phone * (###) ### #### Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country How many ADULT (ages 12 and up) registered citizens are in your household (including yourself)? * 0 1 2 3 4 5 6 7 8 9 How many CHILD (under 12 years old) registered citizens are in your household? * 0 1 2 3 4 5 6 7 8 9 How many ADULT (ages 12 and up) non-Cherokee citizens are in your household (including yourself)? * 0 1 2 3 4 5 6 7 8 9 How many CHILD (under 12 years old) non-Cherokee citizens are in your household? * 0 1 2 3 4 5 6 7 8 9 Please list the names of all registered Cherokee citizens in your household. Are there any Cherokee citizen veterans in your household? If so, please list their names below: Are there any Cherokee elders (60+) in your household? If so, please list their names below: Are you interested in being a volunteer? * Absolutely! I'd like to learn more Not at this time Thank you for your submission. No further health and wellness funds or benefits will be issued for 2025. Willamette Tsa-La-Gi Hat $25.00 T-Shirt $25.00
