Application for membership in Metis Nation of the South
Part 3 Statements and Certification
Applicant's Statement of Oral History and Tradition
"I, ____________________________________, hereby affirm under penalty of perjury, that I am Metis according to the oral history and traditions of my family, and that I meet the definition of Metis as follows: (PLease check all that apply)
___ An indigenous people whose genetic heritage includes aboriginal and non-aboriginal bloodlines;
___ I am descended by blood of American Indian/First Nations Ancestry of the following Tribe(s) or Nation(s)
______________________________________________________________________________,
___ I am descended by blood of Non-American Indian/First Nations Ancestry of the following Tribe(s) or Nation(s)
______________________________________________________________________________.
___ An indigenous people whose individual family's oral and/or written history and traditions affirm and embrace the traditional cultural or social ethos, mores, and practices of the Metis Peoples;
(Please attach a single page statement that describes how you meet this definition.)
___ An indigenous peoples whose members individually consider themselves to be Metis and who are accepted as such by the culture and society of the Metis Peoples. (Please attach a single page statement that describes how you meet this definition.)
Applicant's Signature: ____________________________________ Date: ___/___/_____
Oath of Citizenship
"I, ____________________________________, pledge my oath to the Metis Nation of the South. I promise to uphold the constitution of the Nation and to honor the traditions of my ancestors."
Applicant's Signature: ____________________________________ Date: ___/___/_____
Applicant's Certification
"I, ____________________________________, hereby certify and state upon my oath that, to the best of my knowledge, the information contained within this document is true and correct.
Applicant's Signature: ____________________________________ Date: ___/___/_____
Sponsor's Certification
"I, ____________________________________, residing at ___________________________________ in
___________________________________ do hereby sponsor the above listed applicant for membership in the Metis Nation of the South. Said applicant is:
___ a minor;
___ an incapacitated, incompetent, or other person otherwise in need of assistance;
___ a member of the armed or other government services of Canada, the United States, or Mexico;
___ a member of my immediate family.
I hereby certify that my relationship to the applicant is __________________________________
I hereby further certify and state upon my oath that, to the best of my knowledge, the information contained within this document is true and correct.
Sponsor's Signature: ____________________________________ Date: ___/___/_____
CERTIFICATE OF ACKNOWLEDGMENT
State of ______________ }
County of ______________ }
On __________ (date) before me, __________________________________, the undersigned notary public, personally appeared __________________________________ who is personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature __________________________________ (Seal)
IMPORTANT NOTICE REGARDING PART 3
Print out this form and complete the all the appropriate sections. Once Parts 1 and 2 of the email application reach the Office of Vital Records, you will be contacted by that office and provided with the address where the Part 3 statements should be mailed. If you do not hear from the OVR within 10 days of submission of Parts 1 and 2, please email MNS at metisnation@yahoo.com