Membership Application – Rappahannock Indian Tribe

Membership in the Rappahannock Tribe is based upon one’s ancestry.
To apply, please complete the form below with as much information as possible. Thank you!

Membership Application

APPLICANT

Name *

Indian, Maiden, or other name

Address *

City

County

State *

State

Zip Code *

Zip Code

Gender *

Male

Female

Social Security Number

Date of Birth *

Phone Number *

Height

Weight

Eye Color

Hair Color

Applicant's Children

(A separate application must be filed for each child over 18 years of age.)

Name

Gender

Male

Female

Date of Birth

Date of Death

Place of Birth

Town or County

Place of Birth 2

State or Country

If Married

Date of Marriage

Spouse's Name

Add Remove

SPOUSE'S FAMILY RECORD

Name of Applicant's Wife or Husband

Race

Tribal Name if Indian

Husband

Husband's Name

Date of Birth

Place of Birth

Date of Christening

Place of Christening

Date of Death

Place of Death

Date of Burial

Place of Burial

Date of Marriage

Place of Marriage

Other Wives (if any) Number (1) (2) etc.

His Father

His Mother's Maiden Name

Wife

Wife's Maiden Name

Date of Birth

Place of Birth

Date of Christening

Place of Christening

Date of Death

Place of Death

Date of Burial

Place of Burial

Date of Marriage

Place of Marriage

Other Husbands (if any) Number (1) (2) etc.

Her Father

Her Mother's Maiden Name

ANCESTRY

Col 1 Line 1

Col 2 Line 1

Col 3 Line 1

Great-Grandfather

Col 1 Line 2

Col 2 Line 2

Grandfather

Ethnic Origin

Col 1 Line 3

Col 2 Line 3

Ethnic Origin

Great-Grandmother

Col 1 Line 4

Father

Col 3 Line 4

Ethnic Origin

Col 1 Line 5

Ethnic Origin

Col 3 Line 5

Great-Grandfather

Col 1 Line 6

Col 2 Line 6

Grandmother

Ethnic Origin

Applicant

Col 2 Line 7

Ethnic Origin

Great-Grandmother

Ethnic Origin

Col 2 Line 8

Col 3 Line 8

Ethnic Origin

Col 1 Line 9

Col 2 Line 9

Col 3 Line 9

Great-Grandfather

Applicant's Spouse

Col 2 Line 10

Grandfather

Ethnic Origin

Col 2 Line 11

Ethnic Origin

Great-Grandmother

Col 1 Line 12

Mother

Col 3 Line 12

Ethnic Origin

Col 1 Line 13

Ethnic Origin

Col 3 Line 13

Great-Grandfather

Col 1 Line 14

Col 2 Line 14

Grandmother

Ethnic Origin

Col 1 Line 15

Col 2 Line 15

Ethnic Origin

Great-Grandmother

Col 1 Line 16

Col 2 Line 16

Col 3 Line 16

Ethnic Origin

Signature

Signature of Applicant *

Clear

Date of Application *