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22 N. Eight Tribes Trail Miami, OK 74354
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The Stables Casino
Modoc Nation Gaming Commission
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Red Cedar TG
WalgaMTE
Bison Range
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Red Cedar Shred
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Maklaks Farm
Modoc Domicile
MTFSA
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Modoc History
History
In Memoriam
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Menu
News
Leaders & Staff
Services
Careers
Health Services
Social Services
Child & Family Services
Education
Housing Authority
Tribal Child Support Services
Tribal Services
Tribal Enrollment
Modoc Tag Agency
New Tribal Enrollment Card Registration
Library
Modoc Nation Sesquicentennial (150-year) Calendar
Wellness Center
Environmental Services
Modoc Member Benefits
Businesses
The Stables Casino
Modoc Nation Gaming Commission
EagleTG
Red Cedar TG
WalgaMTE
Bison Range
Craven Media
Red Cedar Shred
Modoc Market
Maklaks Farm
Modoc Domicile
MTFSA
Videos
Modoc History
History
In Memoriam
Shop
Contact
News
Leaders & Staff
Services
Careers
Health Services
Social Services
Child & Family Services
Education
Housing Authority
Tribal Child Support Services
Tribal Services
Tribal Enrollment
Modoc Tag Agency
New Tribal Enrollment Card Registration
Library
Modoc Nation Sesquicentennial (150-year) Calendar
Wellness Center
Environmental Services
Modoc Member Benefits
Businesses
The Stables Casino
Modoc Nation Gaming Commission
EagleTG
Red Cedar TG
WalgaMTE
Bison Range
Craven Media
Red Cedar Shred
Modoc Market
Maklaks Farm
Modoc Domicile
MTFSA
Videos
Modoc History
History
In Memoriam
Shop
Contact
Menu
News
Leaders & Staff
Services
Careers
Health Services
Social Services
Child & Family Services
Education
Housing Authority
Tribal Child Support Services
Tribal Services
Tribal Enrollment
Modoc Tag Agency
New Tribal Enrollment Card Registration
Library
Modoc Nation Sesquicentennial (150-year) Calendar
Wellness Center
Environmental Services
Modoc Member Benefits
Businesses
The Stables Casino
Modoc Nation Gaming Commission
EagleTG
Red Cedar TG
WalgaMTE
Bison Range
Craven Media
Red Cedar Shred
Modoc Market
Maklaks Farm
Modoc Domicile
MTFSA
Videos
Modoc History
History
In Memoriam
Shop
Contact
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Health Services
Social Services
Child & Family Services
Education
Housing Authority
Tribal Child Support Services
Tribal Services
Tribal Enrollment
Modoc Tag Agency
New Tribal Enrollment Card Registration
Library
Modoc Nation Sesquicentennial (150-year) Calendar
Wellness Center
Environmental Services
Modoc Member Benefits
Businesses
The Stables Casino
Modoc Nation Gaming Commission
EagleTG
Red Cedar TG
WalgaMTE
Bison Range
Craven Media
Red Cedar Shred
Modoc Market
Maklaks Farm
Modoc Domicile
MTFSA
Videos
Modoc History
History
In Memoriam
Shop
Contact
Menu
News
Leaders & Staff
Services
Careers
Health Services
Social Services
Child & Family Services
Education
Housing Authority
Tribal Child Support Services
Tribal Services
Tribal Enrollment
Modoc Tag Agency
New Tribal Enrollment Card Registration
Library
Modoc Nation Sesquicentennial (150-year) Calendar
Wellness Center
Environmental Services
Modoc Member Benefits
Businesses
The Stables Casino
Modoc Nation Gaming Commission
EagleTG
Red Cedar TG
WalgaMTE
Bison Range
Craven Media
Red Cedar Shred
Modoc Market
Maklaks Farm
Modoc Domicile
MTFSA
Videos
Modoc History
History
In Memoriam
Shop
Contact
NEW TRIBAL ENROLLMENT CARD REGISTRATION
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