Douglas Kirby

______________________________________________________________________________
Tennessee Native American Convention - Application
------------------------------------------------------------------------------

Position/s applying for: 
[X] Tennessee Native American Convention Board

Caucus: [X] Middle TN 

Information required by TCA 4-34-104 (b)

*   Name: Douglas G Kirby
  
1.  Birthdate: 1952
    Birthplace: Roseville MI
  
2.  Residential address: 6090 CB Hodges, Cumberland Furnace, TN 37051

3.  Educational background
    high school: Sunbright High 
      Did you graduate? 1971
    college: Austin Peay State University
      Did you graduate? B.A. Public Management 1992-1997
    other:

4.  Work (employment) history:
	1999- Present   Cheatham Co. BOE 
	1992-1998 	part time as a  grad asst at ASPU and substitute teaching
	1972-1992   U.S. Army

5.  Tribal heritage: tribe: Cherokee
   [X] member, state-recognized tribe - CTNEA  roll # 3368AD

6. Description of suitability as Commissioner/Advisory Council member/TNNAC Board member/etc:

  I believe I am very capable of working as a board member of TNNAC. I fully 
understand and believe the main and only purpose of TNNAC is to provide a fair 
equalible and accessible voting process for "ALL" the native peoples in TN.
I am also aware of the time required of a board to ensure the above happens 
and am willing to spend that time.

I swear/affirm that this information about me is true, accurate and complete.
signature & date: 

------------------------------------------------------------------------------
Optional information

1. Family 

2. Military experience: U.S. Army retired 20 years 
	Non Commissioned officer combat vet

3. Criminal history: N/A

4. Indian community involvement: 
  Founding member of the Native Cultural Circle of Clarksville TN  
  Active since 1996. V.P. 6 years  President 3 years.
  I have been head man dancer, head veteran, and arena director at numerous pow wows.
  I have been involved in the Order of the Arrow for the past 15 years teaching 
Boy Scouts Native American History and crafts. I also include N.A history in 
my history classes.

I swear/affirm that this information about me is true and accurate.
signature & date: 

______________________________________________________________________________