Application Form For Taino Indian Registry Book of Puerto Rico

Puerto Rico Regional Taino Tribal Affairs Office

Registration Form For Taino Indian Registry

Registration Number: _________________ (Office Use Only) Date: ________________________________

Name:_________________________________________________________________________________

ID# ________________________________________ Telephone:_________________________________

Address:____________________________________________________________________________________

____________________________________________________________________________________________

Family_History:________________________________________________________________________________

____________________________________________________________________________________________

Grandmother (maternal):_______________________________City________________________________

Grandmother (paternal):_______________________________City_________________________________

Grandfather (maternal):________________________________City________________________________

Grandfather (paternal):________________________________City________________________________

Brothers:_____________________________________________________________________________

Sisters:_______________________________________________________________________________

Date of Birth: ________________ City of Birth:________________________________________________

Signature:_____________________________________________________________________________

Return this form with a $1.00 donation (cash or money order only) for file maintenance services to Don Collins Cigars, PO Box 9022651, San Juan, Puerto Rico 00902. (c) Jatibonicu Taino Tribal Nation of Boriken.