Tshano’kai Velokah Tribal Nation

Citizenship Application

Complete in dark ink. Keep a copy for your records.

Safe test packet — mailing is not active.

Application intake is not active. When intake opens and TVTN assigns an application reference number, PDF supporting records may be emailed to applications@tshanokaivelokah.org. TVTN has not published a physical mailing address for applications.

About You

Full legal name:

Date of birth:

Phone number:

Email address:

Street address:

City:

State:

ZIP code:

Your ethnicity codes:

Your lineage codes:

Describe the direct ancestral connection you are presenting:

Ethnicity and lineage choices — use for every person

For you and every person recorded in the direct line, write every ethnicity and lineage code that applies. Use the same choices throughout the packet.

Ethnicity codes

E1 — American Indian
E2 — Black American — Non-immigrant lineage.
E3 — Foundation Black American — With direct-lineal lineage to the founding of the United States.
E4 — Freedman
E5 — Other — Identify: ______________________________

Lineage codes

L1 — Documented records establish that this person or a verified direct-lineal ancestor was recorded in the 1870 U.S. Census or another official U.S. document and was reclassified in a later U.S. Census from Indian, mixed, Colored, Mulatto, Quadroon, or Octoroon to Neg., Negro, or Black.
L2 — Documented records establish that this person or a verified lineal ancestor was classified in the 1920 U.S. Census or an earlier U.S. Census as Free Colored Persons, Black, Indian, Colored, Mulatto, Quadroon, Octoroon, Negro, African Am., or African American.
L3 — Documented records establish that this person or a verified direct-lineal ancestor has documented lineage, citizenship, or membership that connects them to an Indigenous Nation, tribe, or community whose historic homeland is within what is now the United States or its territories.

Indigenous Nation, tribe, or community name, if known:

Family Connections

Provide ethnicity and lineage information for both parents. Then complete one selected direct line through either parent. You may optionally complete one direct line from the other side. TVTN considers documented direct-line descent and does not calculate blood quantum. You are not required to document every family branch.

Your mother

Full name, if known:

Ethnicity codes:

Lineage codes:

Your father

Full name, if known:

Ethnicity codes:

Lineage codes:

First selected direct line: ☐ Mother’s side ☐ Father’s side

Optional second direct line: ☐ Add the other parent’s side

Generation	Continue through mother or father	Name	Birth year	Death year (blank if living)	Place of birth	Ethnicity and lineage codes
Grandparent
Great-grandparent
Great-great-grandparent

Optional second direct line

Generation	Continue through mother or father	Name	Birth year	Death year (blank if living)	Place of birth	Ethnicity and lineage codes
Grandparent
Great-grandparent
Great-great-grandparent

For a deeper direct line, print the TVTN Pedigree Continuation Chart.

Supporting Materials

TVTN Evidence and Record Review Standard

TVTN reviews documented direct-line ancestry in context. TVTN recognizes that historical and present-day records may be incomplete, inconsistent, inaccurately classified, or changed over time.

TVTN may consider official United States historical or present-day records, tribal rolls and related tribal records, and other documented evidence that helps establish or explain a direct ancestral line. This may include family-held materials, such as family Bibles, and verified statements from elders or other knowledgeable persons.

No single historical classification, record label, or document type automatically confirms or defeats an application. TVTN evaluates the complete record, the connection of each item to the claimed direct line, and any available corroborating evidence.

For each item submitted, the applicant should identify the person named in the record, the source or custodian, the date or approximate period, and how the record connects that person to the direct line. Family-held or community evidence should identify its source, relationship to the family, date, and basis of knowledge. TVTN may request clarification, additional records, or verification before reaching a decision.

Submission of evidence does not guarantee approval, citizenship, membership, eligibility, or acceptance.

Person named	Source/custodian	Date/period	Evidence type	Connection to direct line

For family-held or community evidence, identify the source, relationship to the family, date, and basis of knowledge:

Document delivery: When intake opens and a reference number is assigned, email PDF copies to applications@tshanokaivelokah.org and include the reference number in the subject. Documents are not uploaded to the website or stored in the application database.

Review & Sign

Privacy notice

TVTN collects this information to review the application, verify evidence, communicate with the applicant, and preserve the Nation’s official decision record.
Only named, authorized TVTN staff accounts may access submitted applications and records.
TVTN does not publicly display or sell applicant information or supporting records.
Application questions and corrections use applications@tshanokaivelokah.org.
TVTN’s approved retention policy and effective date will be published before applications are accepted.

Applicant Attestation and Electronic Signature

☐ I confirm that I am 18 years of age or older.

☐ I certify that the information and supporting materials I provide in this application are true and correct to the best of my knowledge.

I understand that TVTN may request additional information, records, or verification before making a determination. I understand that submitting this application does not guarantee eligibility, citizenship, membership, or acceptance by TVTN.

By checking these boxes and typing my full legal name below, I intend to sign this application electronically.

Electronic signature — type your full legal name:

Date signed: