MEMBERSHIP APPLICATION

Bras d’Or First Nations Community

 

 

 

Applicant Information:                                                                            

 

Family Name	Given Names
Street Address or P.O. Box Number	City/Town	Province			Postal Code
Date of Birth (dd/mm/yy)	Home Telephone No.		Work Telephone No.
Email	Alternate Email Address

 

For each child under 18 listed on application, please include copy of Long Form Birth Certificate.

 

Child’s Full Name	Birth Date (dd/mm/yy)

 

If known, list family member who already has membership in the Bras d’or First Nation Community.

___________________________           _______________________        _______________

Name                                                                                       Relationship                                                             BIFN Band #

 

Certification:

I hereby certify that the information submitted herein is true and correct to the best of my knowledge. I further certify that I am not on any other band list.

                                   _______                       _______________
Applicant Signature                                         Date

 

Mail application to:       The Bras d’or First Nations Community

788 Main Street, Sydney Mines

Cape Breton, B1V 2L6

 

Please be sure to attach all required documentation as well as the PEDIGREE to your application.

Do not forget to include a self-addressed stamped envelope with EACH application and the $25.00 administration fee to cover costs associated with printing and issuing a Membership Card.

 

If you have any questions, please contact us at the address above, by calling 902-736-1028, or emailing zaxciel@hotmail.com

 

 

Approved:        _________________________    _____________       BDFN-__________

 (Signature of Chief)                                               Date:                                       Band Number