CHEYENNE & ARAPAHO TRIBES OF OKLAHOMA VOTER REGISTRATION FORM

Name*

First NameLast Name

Maiden Name

Tribal Roll #*

DOB*

Date

Telephone No*

Email*

example@example.com

Other Names Used*

Mailing Address*

City*

State*

Zip*

Address of Residence (if different than your mailing address)

Are You a Current Registered Voter?*

What is your current district?*

Check one*

AbsenteeIn Person

What type of Registration is this?*

Tribal Affiliation from * to *

Please check one if this is a New, District, or Tribal Affiliation Change

C-1 (Seiling, Watonga, Longdale, Canton)C-2 (El Reno, Calumet, Kingfisher, Geary, Greenfield)C-3 (Thomas, Deer Creek, Weatherford, Colony, Clinton)C-4 (Hammon, Elk City)A-1 (Seiling, Watonga, Longdale, Canton)A-2 (El Reno, Calumet, Kingfisher, Geary, Greenfield)A-3 (Thomas, Deer Creek, Weatherford, Colony, Clinton)A-4 (Hammon, Elk City)

In accordance with the "Cheyenne & Arapaho Tribes Constitution Article IX Sections 1 & 2":

A. Members of the Tribes age (18) eighteen or older shall be eligible to vote in an election;

B. Cheyenne voters shall register in the Cheyenne Districts in which they reside. Cheyenne voters who do not reside within a Cheyenne District shall register to vote in any Cheyenne District; provided that once registered in such District, the voter shall not be permitted to change districts unless he or she establishes residency in another Cheyenne District;

C. Arapaho voters shall register in the Arapaho Districts in which they reside. Arapaho voters who do not reside within a Arapaho District shall register to vote in any Arapaho District; provided that once registered in such District, the voter shall not be permitted to change districts unless he or she establishes residency in another Arapaho District;

D. A member of the tribes who possesses both Cheyenne and Arapaho blood shall register to vote in either a Cheyenne District or an Arapaho District, provided that such member may only change from a Cheyenne District to an Arapaho District or from an Arapaho District to a Cheyenne District, once;

E. A member who is properly registered to vote in a District shall not be required to re-register to vote unless the member establishes residency in another district or fails to vote in (2) two consecutive elections.

I certify I have read and understand the Cheyenne & Arapaho Constitution Article IX, Section 1 & 2 and all the information given is true and accurate.

Signed (Registered Voter)*

Date*

Date

C & A Tribes of Oklahoma, Election Commission, PO Box 89, Concho, OK 73022, 1-800-247-4612, ext 27619

CHEYENNE & ARAPAHO TRIBES OF OKLAHOMA VOTER REGISTRATION FORM

DISTRICTS