Mid Island Métis Nation — Membership Application
26-1708 Bowen Road, Nanaimo, BC V9S 1G9 · 250-585-7441 · office@mimn.ca

Membership & citizenship

Membership application

Fill this in at your own pace. Then print it, sign it, and bring it to the office.

Your answers stay on this computer.

Nothing is sent to MIMN or anyone else while you type.
Your answers are saved in this browser, so you can stop and come back later.
The PDF is made on this computer too. You choose whether to email it or bring it in.
Your documents and ID come in person — never email those.
On a shared or library computer, press Erase my answers when you are done.

About you

Please use your full legal name, exactly as it appears on your birth certificate.

Last name First name Middle name Date of birth Place of birth

How we reach you

Tell us if any of this changes while your application is being reviewed.

Street address City Province Postal code Phone (home) Phone (work or cell) Email

For your membership card

These details are printed on the card itself.

Sex

Male Female

Eye colour Height Weight

Your Métis line

MIMN needs a birth or baptismal certificate for each person below, going back to 1901. Fill in what you know. If you get stuck, call the office at 250-585-7441 — this is the part people most often need help with.

Your Métis parent

Use the maiden name for women.

Full name Date of birth Place of birth

Your Métis grandparent

The parent of the person above.

Full name Date of birth Place of birth

Your Métis great-grandparent

The parent of the person above.

Full name Date of birth Place of birth

Anything else about your family history that may help

The full 5-generation pedigree chart is a separate paper form in the application package. Please fill that in as well. Genealogy approval usually takes 1 to 3 months.

Documents to bring

Tick these off as you gather them. Do not upload or email them — bring copies to the office, or send them by mail.

Birth or baptismal certificate — you
Birth or baptismal certificate — your Métis parent
Birth or baptismal certificate — your Métis grandparent
Birth or baptismal certificate — your Métis great-grandparent
Completed 5-generation pedigree chart
Status-card sized photograph (face, neckline up)
BC photo ID — driver's licence, BC ID, or passport (under 18: BC Care Card)
Signed, dated and witnessed Consent to Release form
Copy of your MNBC citizenship card, if you have one

What you are agreeing to

This is a plain-language summary. The wording that counts is on the paper Consent to Release form, which you sign in front of a witness.

Acceptance is decided by the President and Board of Mid Island Métis Nation. Submitting this form does not by itself make you a member.

Signature

I confirm the information on this form is correct.

Signature

Print full name

Date

Bring this signed form to the office with your documents, or attach the PDF to an email to office@mimn.ca. Your Consent to Release form must be signed in front of a witness.

Finishing up

Press Save as PDF. In the window that opens, choose Save as PDF as the destination, then save the file.
Print it and sign it, or attach the PDF to an email.
Sign the Consent to Release form in front of a witness.
Bring everything to the office, mail it to 26-1708 Bowen Road, Nanaimo BC V9S 1G9, or email the PDF to office@mimn.ca.
Bring your documents and ID in person — please do not email those.

Questions? Call 250-585-7441 or email office@mimn.ca. A real person answers.

Membership application

About you

How we reach you

For your membership card

Your Métis line

Your Métis parent

Your Métis grandparent

Your Métis great-grandparent

A few questions

Documents to bring

What you are agreeing to

Finishing up