Application Request for Enrollment
Give a full name of person for whom the application is being requested for. Instructions and requirements for Enrollment are on the first page of the packet. PLEASE READ carefully before filling out the application-this is very important. Your application must be completed with necessary documentation before Enrollment committee review.
The Birth Certificate from the Vital Statistics Office will be copied, embossed within the office by staff, for security purpose it will be returned to you by mail Certified.
Social Security Consent for Release of Information form. Fill out the necessary information for yourself or other family members, take this form to the nearest Social Security Administration Office and ask for a PRINT OUT.
For the Security of the Smith River Rancheria tribal members, parents of minors who share joint custody we have to have a court document stating which parent the child is residing with.
If you are 18 years or older you must call the Tribal Office and update any change yourself. If other family members call in the change we need a court order or power of attorney for them to do so.
We can’t change our records without a legal document; for Marriages we need a copy of your Marriage Certificate, for Divorce Decree we need copy of court document stating the change of your legal name, Legal Name Change we need copy of court document stating the change.
Tribal Id’s are available to children 10 years and older. Stop by the Tribal Office front desk and ask for the ID form. Verification is done by Enrollment staff, your Enrollment number and Date of Birth plus signature of staff. You will then be directed to the Tribal Gaming Agency where your picture will be taken.
Submitted by Theresa Ferrer, Enrollment Specialist
Smith River Rancheria
140 Rowdy Creek Road
Smith River, CA 95567
(707) 487-9255 x3120 Fax: (707) 487-0930 or firstname.lastname@example.org