Cowlitz for Accountability
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Name
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First Name
Last Name
Email
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example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
What type of phone number is this?
Landline
Mobile
Would you like to receive text messages from Cowlitz for Accountability?
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Would you like to be added to the Cowlitz for Accountability Facebook Group?
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Which best describes your relationship to the Cowlitz Indian Tribe?
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Enrolled Cowlitz Tribal Member
Lineal Descendant of a Cowlitz Tribal Member (not enrolled)
Spouse of an Enrolled Cowlitz Tribal Member
Custodial Parent/Guardian of an Enrolled Minor Cowlitz Tribal Member
Enrolled Cowlitz Tribal Members
What age group are you a member of as of December 31, 2024
Ages 62 & Over
Ages 55-61
Ages 50-54
Ages 40-49
Ages 30-39
Ages 20-29
Ages 18-19
Ages 17 & Under
Parent/Legal Guardian Information
First Name of Parent/Legal Guardian
Last Name of Parent/Legal Guardian
Parent/Legal Guardian Email
example@example.com
Parent/Legal Guardian Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Lineal Descendants
not currently enrolled in the Cowlitz Indian Tribe
Please provide the following details about the enrolled Cowlitz Tribal Member you are a lineal descendant of.
First Name Descendant
Last Name Descendant
Relationship
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Parent
Grandparent
Great-Grandparent
Great-Great-Grandparent
Sibling
Aunt/Uncle
Cousin
Are you now or have you ever been enrolled in another tribe?
Please Select
Yes (still enrolled)
Yes (no longer enrolled)
No
Name of the Tribe
Why are you not enrolled in the Cowlitz Indian Tribe?
Spouse of an Enrolled Tribal Member
May we verify your information with your spouse?
Please Select
Yes
No
Spouse’s Name
First Name of Spouse
Last Name of Spouse
Spouse’s Email
example@example.com
Custodial Parent/Guardian of an Enrolled Minor
Name(s) of enrolled Cowlitz minor child(ren):
Disclaimer Confirmation
Disclaimer:Cowlitz for Accountability is an independent group and is not an official organization of the Cowlitz Indian Tribe, nor does it represent the tribe in any official capacity.
Acknowledgment:I have read the disclaimer and understand that this group is an independent group and is not an official organization of the Cowlitz Indian Tribe, nor does it represent the tribe in any official capacity.
*
Yes, I understand.
No, I do not understand.
Please explain what is unclear to you about the disclaimer:
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