Beginner 1 Language Course Enrollment Form – Language Course: Peoria Tribe of Indians of Oklahoma

Enrollment

Name (As it appears on your Tribal ID Card)(Required)

First Middle Last

Date of Birth(Required)

Email(Required)

Phone(Required)

Mailing Address(Required)

Do you have access to reliable high speed internet?(Required)

Yes

*Computer or tablet recommended

Are you a Peoria citizen?(Required)

Yes

Are you a household member of a Peoria Citizen?

Yes

Name of the Peoria Citizen in your household (As it appears on their Tribal ID Card)(Required)

Your relationship to Peoria Citizen(Required)

Citizen's Tribal Enrollment Number

Your tribal roll number and personal information will be kept private, and used only for the purposes of enrollment in this course.