Application for Membership
PERSONAL INFORMATION

PLEASE PRINT CLEARLY AND COMPLETE EACH SECTION

Part IFirst Name: _________________________ Last Name: _________________________ Middle Initial(s): _______
Address__________________________________________________________________________________ ___City: __________________________________ Province: ___________________ Postal Code: _____________
Date of Birth dd:____ mm:____ yyyy:_______ Place of Birth: __________________________________________
Phone: ____________________ Work: ____________________ Mobile:__________________ Fax: ____________
Email Address: _____________________________________ Website: __________________________________Part II
Gender:  M  F Eye Color: _______ Height(cm)______ Weight(lbs)______
Marital Status:  Single  Married  Separated  Divorced  Widow  Common-Law  Domestic Partners
EDUCATION

PLEASE SELECT HIGHEST LEVEL COMPLETED

 Elementary  Some High School  High School  College  University (Undergrad) University(Grad)
Current Occupation: ____________________________________________________________________________ABORIGINAL ANCESTRY________________________________________

WHICH OF YOUR ANCESTORS WERE MEMBERS OF A BAND

Aboriginal?  Yes

 NoFather________________________________________

Treaty Area
Aboriginal?  Yes

 NoFather’s Mother________________________________________

Aboriginal?  Yes

 NoAboriginal?  Yes

 No

Mother’s Father____________________________
Treaty Area

Aboriginal?  Yes

 No

Mother’s Mother____________________________________________________________________
Treaty AreaMother____________________________________________________________________
Treaty Area

Father’s Father________________________________________________________________________________________________
Treaty Area

Aboriginal?  Yes No____________________________
Treaty Area

ABORIGINAL STATUS

PLEASE CHECK ONE

 Métis Status Indian with Band Membership Non-Status Indian Métis with Status Card

 Status Indian without Band Membership InuitABORIGINAL HARVESTING RIGHTS Non-Native

SPECIFY TRADITIONAL HARVESTING RIGHTS YOU WISH TO CLAIM

Identify the traditional harvesting rights you wish to claim. Specify your Ancestral Area and the boundaries within which you
claim these rights. (If necessary, please attach a map outlining the areas.)
Rights Claimed

Specific Geographic Region

Fishing (lakes, streams)________________________________________________________

Hunting (forests, valleys)________________________________________________________

Trapping (boundaries)________________________________________________________

Wild Rice Harvesting (lakes, streams)________________________________________________________

Medicines & Resources (boundaries)________________________________________________________

Other Plants (boundaries)________________________________________________________

Reason for Claiming the Above________________________________________________________TYPE OF MEMBERSHIP SOUGHT FULL - Any person of Aboriginal descent within the meaning of s35(2) of the Canada Act, 1982 but NOT aband member residing on a reservation.
 YOUTH - Same as FULL membership, only the applicant is under 18 years of age.

 ASSOCIATE - Non-Status Indians, Status Indians or Individuals with Band Memberships who live on a reservation.

SELECT YOUR PAYMENTMEMBERSHIP FEESOne Year Membership: FULL (Per Person) = $20.00

 YOUTH = $10.00

Associate = $15.00

4 year Membership: 

5 year Membership: thMembership Renewal: (Buy 4 years, Get 5 Year Free)
2 year Membership: 

3 year Membership: 

Full: $35.00

Fee: $45.00

Fee: $60.00

Fee: $60.00

Youth: $15.00

Fee: $20.00

Fee: $25.00

Fee: $25.00

Associate $25.00

Fee: $35.00

Fee: $45.00

Fee: $45.00*Please Note - Youth Memberships may only be renewed in if the applicant will remain under the age of 18 forthe full term of renewal.

PHILANTHROPYWOULD YOU LIKE TO MAKE A DONATION TO OMAA-THE WOODLAND MÉTIS TRIBE?

 I would like to pledge $______ annually / monthly ( please circle one) in support of Rights Based Challenges,Métis Student Bursaries, or other Métis Cultural Programming.

METHOD OF PAYMENTPLEASE MAKE CERTIFIED CHEQUES OR MONEY ORDERS PAYABLE TO OMAA THE WOODLAND MÉTIS TRIBE

Total: $_________

 Certified Cheque Money OrderOATHI hereby make application for membership with the Ontario Métis Aboriginal Association – The Woodland Métis Tribe and doswear that all of the information contained herein is true to the fullest extent of my knowledge. I understand that providing
false statements or impersonating another individual within this application is considered a criminal act and will be punished tothe fullest extent of the law. Should my application be accepted, I further agree to abide by the Constitution and By-Laws ofOMAA - The Woodland Métis Tribe, along with all future amendments and pay the annual membership fees specified to me
within this application. I understand that my membership may be revoked at any time, should I fail to adhere to the guidelines
set within the Membership By-Laws. In the event that my card is lost, stolen or damaged, I agree to pay a $5 replacement fee.

Signature of Applicant: _____________________________________

Witness: ______________________________ Date: _____________COMPLETE THE ABOVE AND MAIL PAYMENT ALONG WITH ONE PASSPORT-STYLE OR PHOTO BOOTH PHOTO* TO:OMAA - The Woodland Métis Tribe
203 Hardisty StreetThunder Bay, Ontario
P7C 3G8CANADAIf you have any questions or need assistance with filling out this form, please phone us at: +1 (807) 622-5249*NOTE: PLEASE DO NOT SEND PHOTOS PRINTED ON REGULAR PAPER. DO NOT SEND CROPPED, RETOUCHED orOTHERWISE DITGITALLY ALTERED PHOTOS. SENDING PHOTOS OTHER THAN THE REQUESTED FORMAT WILLRESULT IN YOUR APPLICATION BEING DELAYED UNTIL THE APPROPRIATE TYPE OF PHOTO IS RECEIVED.