Mail to: Subsistence Coordinator, Wrangell-St. Elias NPP, PO Box 439, Copper Center, AK 99573 or 

Email to: barbara_cellarius@nps.gov 

National Park Service Subsistence Resource Commission 

Membership Summary Checklist 

Information for membership on the Wrangell-St Elias National Park Subsistence Resource 

Commission: 

_____ New Appointment OR ____ Re-Appointment

First Name:_____________ Middle Name:__________ Last Name: _____________________ 

Mailing Address: _______________________________________________________________ 

Date of Birth: __________________________________________________________________ 

Occupation: ___________________________________________________________________ 

Telephone Contact Numbers

Home: _____________________________________________________________________ 

Work: _____________________________________________________________________ 

Cell: ______________________________________________________________________ 

Fax: _______________________________________________________________________ 

Email Address: ________________________________________________________________ 

1) Physical address of nominee's primary place of residence?

______________________________________________________________________________ 

2) What has been nominee’s involvement with subsistence activities within the national 

park? ________________________________________________________________________ 

______________________________________________________________________________ 

______________________________________________________________________________ 

______________________________________________________________________________ 

______________________________________________________________________________ 

3) Describe nominee’s experience serving on other councils, committees, boards, and 

organizations or working groups? (Organization names, dates, role (e.g., member, officer)) 

______________________________________________________________________________ 

______________________________________________________________________________ 

______________________________________________________________________________ 

______________________________________________________________________________ 

______________________________________________________________________________ 

(Continues on next page) 
Mail to: Subsistence Coordinator, Wrangell-St. Elias NPP, PO Box 439, Copper Center, AK 99573 or 

Email to: barbara_cellarius@nps.gov

Reference Contacts: List three references. Please provide name, address, and phone number or 

email address.

1. Name: __________________________________________________________________

Address: ________________________________________________________________

Home Phone Number: ____________________________________________________

Work/Cell Phone Number: ________________________________________________

Email Address: __________________________________________________________

2. Name: __________________________________________________________________

Address: ________________________________________________________________

Home Phone Number: ____________________________________________________

Work/Cell Phone Number _________________________________________________

Email Address: __________________________________________________________

3. Name: __________________________________________________________________

Address: ________________________________________________________________

Home Phone Number: ____________________________________________________

Work/Cell Phone Number: ________________________________________________

Email Address: __________________________________________________________

Additional Information: ________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Attach additional sheets as needed.