NJC Membership Update

Please complete the form below:

Title	*
First Name	*
Middle Name	*
Last Name	*

Address	*
City	*
Zip / Postal	*
State / Province	*
Email Address	*

Cell Number
Home Number

Tribe Name	*

Title	*
Spouse First Name
Spouse Middle Name
Spouse Last Name

Child First Name - Under 18
Child Middle Name - Under 18
Child Last Name - Under 18
Gender

Child First Name - Under 18
Child Middle Name - Under 18
Child Last Name - Under 18
Gender

Child First Name - Under 18
Child Middle Name - Under 18
Child Last Name - Under 18
Gender

Child First Name - Under 18
Child Middle Name - Under 18
Child Last Name - Under 18
Gender

Child First Name - Under 18
Child Middle Name - Under 18
Child Last Name - Under 18
Gender

How long have you been a member of NJC?