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By filling out the form below and clicking the "submit" button you are giving your
electronic signature and attesting that you acknowledge that you are a member of the Lost
Cherokee of Arkansas and Missouri (aka Arkansas Cherokees, Cherokees on the Arkansas
River, Lost Cherokee Group, Arkansas Cherokee Nation, Lost Cherokee Nation, Lost Cherokee
Nation Economic Development Company, Lost Cherokee Tribe of Arkansas and Missouri), as
represented by the Lost Cherokee of Arkansas and Missouri Inc., and tribal Headmen Cliff
Bishop, Curtis Smith and Don Harness, as well as Tribal Councilmen Buddy Whiteley, John
Brown, and Morris Chiles. By signing this form below you also affirm that you are not a
member of any other Native American entity, tribe or group-federally recognized or
unrecognized.
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First Name
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*
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Middle Name
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Last Name
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*
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Roll Number
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*
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* Indicates required Field
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