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Join AICCOK.
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(denotes required field)
Date
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Company or Individual Name
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Tribal Affiliation
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Main Contact
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Title
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Address
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City
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State
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Zipcode
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Phone
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Fax
E-Mail
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Website
Number of Employees?
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Check One:
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New Member
Renewal
Please Describe The Nature Of Your Business
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Industry Heading To Be Listed Under?
Annual Dues:
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Companies with 1-10 employees - $100
Companies with 11-20 employees - $150
Companies with 21-99 employees - $200
Companies with 100 or more employees - $350
Individuals - $75
Students - $25
51% Indian Owned:
*
Yes
No
For membership with full voting privileges, company must be 51% Indian owned. Please upload a copy of your CDIB or tribal enrollment from a federally recognized tribe below..
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