Please print
OR FAX THE PAGE BELOW
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First Name:___________________Last Name_____________________
Address _______________________________
City ___________State _____ Zip Code _____________
Email address ____________________
Date of Birth _________________
Home Phone ___________________
Work Phone ___________________
Tribal Affiliation or Tribe: ________________
M/F ___________________
Faith ________________
Do you want us to help you search? ___________
Tell us about yourself:
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Tell us about your ancestors
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Are you registered with any tribes?
Because we process all of the information, papers, ID Cards, certificate and other processing we cannot offer a refund for membership. Do you agree to this?_________
If there is a problem we will rectify it.
Please fax this application back to 206-339-4673
Please fax your CC info along with the total amount to be charged.
Total amount is $_______
Credit Card Number: ________ | ___________ | __________ | ___________
Exp Date _____ | ______
CVV Numbers on back _ _ _
[The 3 #'s on the right on the back of the card]
I agree to the terms above for Tribal membership to Binay.
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Signature of Authorized applicant.
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Signature of Authorized witness
Relationship to applicant?
_____________________
Tribal Office Info:
Monroe Enterprises
[Binay Membership]
74 Horst Ave
Suit B
Chambersburg, PA 17201
717-496-8527 [Tribal Office]
206-339-4673 [Fax Number]
If you are already a member, Please let us know if you have not received your membership packet. Please include the payment # you received when you made a payment.Thank you.
We no longer have monthly dues or fees. Our membership is now a one time full membership to the tribe. The Application is now only $100.00 for full membership.
Please use our online payment form. Or you can send it it by mail. Please note that all personal checks or money orders will take 5 to 10 business working days before any membership will be sent.
You must E-mail or mail in a Clear Color Photo of your face. It must be Passport type. If it isn't then it will delay your membership.
Please be sure not to have on shades or hats or scarf on your head. There are no exceptions.
Once all information has been received we will process your application and prepare your membership packet and it will be sent.
You will receive the following items:
A Tribal ID Card = Must be respected and used according to the documents sent along with your membership packet.
A Certificate of Membership
An official welcome letter
And instructions and links to our online chats, files and research materials. Along with meeting dates and chat schedules.
If you have any questions please let us know at blackindianz@aol.com
Welcome to the Tribe.
The Binay Tribe
BlackIndians.com