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918.542.1190
Mon - Fri: 8:00 - 4:30
22 N. Eight Tribes Trail Miami, OK 74354
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Menu
ABOUT
Leaders & Staff
News
History
Videos
SERVICES
Careers
Environmental Services
Health Services
Housing Authority
Modoc Nation CCDF
BUSINESSES
A-B-C Therapy
Craven Media
EagleTG
Harpy Technologies
Healing House
Hope Ranch
Lost River Treatment Center
Modoc Domicile
Modoc Nation Ranch
MTFSA
Red Cedar Recycling
Red Cedar Shred
Red Cedar TG
The Stables Casino
Modoc Nation Gaming Commission
WalgaMTE
Wellness Center
MEMBER BENEFITS
Tribal Enrollment
New Tribal Enrollment Card Registration
Member Services
Education
License Tag Agency
Library
Wellness Center
CALENDAR
CONTACT
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Instagram
NEW TRIBAL ENROLLMENT CARD REGISTRATION
Modoc Nation offers a variety of services to our members.
Full Name
Maiden Name
Date of Birth
Male
Female
Mailing Address
Phone Number
Email
Social Security Number
Citizenship #
Photo Requirements:
•Photos are required for all adults 18 & older but are optional for minors
•Must be in color
•Taken within the last 6 months to reflect your current appearance
•Taken in front of a plain background
•Be solely of the applicant, no other people in view of the camera
•Taken in full-face view directly facing the camera
•Do not wear a hat or head covering that obscures the hair or hairline, unless worn daily for a religious purpose.
Please select one:
Only use my likeness to produce this form of identification.
I hereby grant permission to Modoc Nation to use my likeness to produce this form of identification AND in publications, news releases, online, and in other communications related to the mission of Modoc Nation.
Photo
Date Signed
Printed Name of Signer
Signature of Adult Applicant or Signature of Parent/Guardian if applicant is under 18 years of age
❌
By signing, applicant certifies that all information is true and correct to the best of their knowledge.
Preferred Delivery Method
1. Mailed to the address listed on the form
2. Pick up in person at 22 N. Eight Tribes Trail Miami, OK 74354.
Send
Modoc Nation