Long Lake 58 Members: Please Update your Contact Information

Question Title

* 1. Boozhoo! Please keep your contact information up to date. We use this information to contact the membership for voting, elections and other band matters. Please fill out this form to make sure your information is current. Miigwetch!

Your First and Last Name on your Status Card *

Date of Birth *

Mailing Address *

Apartment Number

P.O. Box

City *

State / Province *

ZIP / Postal Code *

Email Address

Phone Number

Question Title

* 2. Do you use any of the following?

Facebook

Email

Internet/Google

Twitter

None of the above