Eastern Shore Métis Nation

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1 Eastern Shore Métis Nation 1228 Dover Road Little Dover, Nova Scotia B0H1V0 Phone: or Name of Applicant Last First Middle Mailing Address: Street P.O.Box City or Town Province Postal Code Telephone: Home ( ) Cell ( ) Do you self-identify as Métis? YES NO Date of Birth: / / Sex: Male Female Month Day Year Height: Feet Eye Color: Spouse s Name: Last (Maiden) First Middle Children s Names Birth Dates

2 ABORIGINAL ANCESTRY CHART Please note: All applicants must have a verified genealogy presented to us prior to applying for membership, with DNA test results signed by your family doctor, police officer, dentist or lawyer that it was taken in front of them as a witness. The DNA is used to prove that your genealogy is true and correct. Please fill out Aboriginal side as complete and accurate as possible. Lack of documentation can cause longer delays in verification. Don t forget to attach a photocopy of your genealogy (family tree) with this form to prove your aboriginal lineage. Name of (use maiden names Your Mother Date of Birth (M/D/Y) Where was she/he from? (town/province) Does she/he have aboriginal ancestry? If yes, please indicate Métis/FN/Inuit Your Father Your mother s Mother Your Mother s Father Your Father s Mother Your Father s Father **ATTACH ALL DOCUMENTATION YOU HAVE TO PROVE YOUR ABORIGINAL ANCESTRY** All material I submit in this certification and genealogy is true and accurate to the best of my knowledge. I understand that any misleading information will result in the termination of my Eastern Shore Métis Nation membership card. Signature: _ Date:

3 Eastern Shore Métis Nation Phone: Your Eastern Shore Métis Nation membership card: This is the back of your membership card. Please sign the appropriate signature box below. (Be sure to include this page with your application - also please stay within the lines) X Signature Is Aboriginal under Section 35 (1)(2) of the C anadian Constitution Act, X R e giona l C hie f's Signa ture Please enclose a $75.00 Cdn. cheque or money order made payable to: Eastern Shore Métis Nation Association This is a processing fee and it is non-refundable. Card will be renewed annually once the annual dues of $25 are paid. A new passport photo is required every 5 years, which makes them more accurate as a form of Photo ID. If you have lost or wish to renew your card, the cost for the renewal will be $ Children under 18 years of age or in university shall NOT pay the $75.00 application fee or the annual fee of $25.00; all that is requested is a $15.00 fee for a membership. Children under 16 will not receive a membership card. They will receive a membership number in the form of a sealed letter. Once a child turns 16 they can request that they be issued a membership card. Things you need for a new Membership Please note: All applicants must have a verified genealogy presented to us by a certified genealogist prior to applying as a member or A DNA test signed by your family doctor, police officer, dentist or lawyer that it was taken in front of them as a witness. Application filled out and signed on ancestry chart, and the last page Copy of driver s license or government ID Copy of your long form Birth Certificate or Baptismal Certificate

4 You need 2 actual passport photos from Walmart, Costco, etc We do not have a certified genealogist on site and the applicant must provide a valid copy of his or her genealogy since our organization is not responsible to research a person s genealogy. The information provided must show how the applicant is connected to the genealogy enclosed Genealogy or Ancestry documentation* Cheque or money order for written out to Eastern Shore Métis Nation Association Mail applications to: Eastern Shore Metis Nation Association 1228 Dover Road Little Dover, NS B0H-1V0 If you already had an existing Card with another organization and want to Join our local Band You will need a copy of your existing Card You will need to fill out a new application with us, with ancestry page and last page signed You need 2 actual passport photos from Walmart, Costco, etc You will need a copy of your genealogy or ancestry documentation* We do not have a certified genealogist on site and the applicant must provide a certified copy of his or her genealogy since our organization is not responsible to research a person s genealogy. The information provided must show how the applicant is connected to the genealogy enclosed Copy of your long form Birth Certificate or Baptismal Certificate Copy of driver s license or government ID The $75.00 Application Fee payable to Eastern Shore Métis Nation Association *For people who are looking to get genealogy research done, you can contact any council member and they will guide you to someone who can help you.

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