Tennessee Native American Convention 2003
N O M I N A T I O N   F O R M
Use this form if you want to be nominated
to be a Commissioner of Indian Affairs or
or another state commission, at the
TN Native American Convention in
september 2003 at Pinson Mounds.

legal basis for this nomination form:
proposed Tennessee Code Annotated:
Tennessee Commission of Indian Affairs

SECTION 5.
    (b) (2) Accompanying each nominee's name submitted shall be a résumé, including the nominee's educational background, work history, heritage, description of why the nominee would be a suitable commissioner, and the democratic process and results that led to the nomination.
         (3) Preference in selection of at least five (5) Indian Commissioners shall be given to Native American Indians, i.e., persons having origins in any of the original peoples of North America, and who maintain cultural identification through tribal affiliation or community recognition.
         (4) Each member of the Commission of Indian Affairs shall be a resident of Tennessee.
(f) Commissioners shall be at least eighteen (18) years of age upon their appointment and shall have been residents of Tennessee for at least one (1) year.

Tennessee Native American Convention

According to the proposed law cited above, the Tennessee Native American Convention needs to submit to the state a résumé for each commissioner nominee. We ask for this information in order to support your nomination to the Commission as strongly as possible. This is information (a) for the State and (b) for the state Native American population to get to know you better. We do this online because we do not have paid staff and because data entry online reduces the number of times the data has to be input and eliminates the need to interpret handwriting. Incomplete or unintelligible forms will be processed as is. TNNAC assumes no responsibility for wrong, incomplete, unintelligible or missing information.

TNNAC will print out your résumé form and add to the bottom of the last page words to the effect that you swear/affirm that all the information you have given about yourself is true. You will need to sign and date the résumé.

FYI: The state Speakers of the House and Senate and Governor have the right to request a background check (criminal and civil) on any person considered for appointment to a state commission.

This web-based form is sent directly by email from Chattanooga Online (chattanooga.net) to TNNAC chairman tom kunesh/tpkunesh@chattanooga.net. It goes nowhere else. Information in the plain white areas will be shared with the public. Information in the pink areas will be shared only within TNNAC (with those TNNAC board officers who have a need to know, not the complete TNNAC board) and records authorities. If you have any concerns about this process or this form, please contact him: tpkunesh@chattanooga.net, 423/ 624-3380.

If you do not send this information in to us, we will simply note that no further information was received from you.

Please also send (2) proofs of Tennessee residence (utility bills [gas, water, electric, phone] with your name and home address in Tennessee on it and a copy of your state's drivers license [cross out any SSN or ID number]) and (2) your Native American Indian tribal/genealogy data to:

TNNAC, box 1063, Chattanooga TN 37401.

Indian Commissioner Nominee résumé

1. Personal Data
2. Native American Indian Heritage
3. Educational Background
4. Military Experience
5. Extracurricular Activities
6. Work History
7. Background Information
8. Personal References
9. Personal Statement

0. Position and Division
I am applying to be a nominee for:
from:
1. Personal Data
Please use capital letters only at the beginning of proper names.
Do NOT use ALL CAPITAL LETTERS.

full birth name:
other name
(eg, Indian or married):
birthplace
(town, county, state):
birthdate (day/month/year):
TNNAC will post your birth year, not the day or month.
father's & mother's names: TNNAC will not share this information.
Are these your natural birth parents?       yes       no TNNAC will not share this information.
your residential address
(no PO box):		 TNNAC will not share this information.
city:     county:    state:    zip:
two (2) proofs of residence
(eg, drivers license
+ utility bill):		 TNNAC will not share this information.
area code & phone numbers
: home
: work TNNAC will not share this information.
email address:
current marital status:       single       married       divorced
spouse's/partner's name:
children's names & ages: TNNAC will not share this information.
Are you a citizen of the USA?       yes       no
How long have you been a
resident of Tennessee?
 

2. Native American Indian Heritage
TNNAC will not share roll nor enrollment numbers nor genealogies.
 
Are you a member of a USA-federally-recognized tribe?

If so, the tribe's name, location, and enrollment number:
* You will need to send us supporting documentation
to establish and substantiate your claim.

 yes       no

 
Are you a member of a state-recognized tribe?

If so, the tribe's name, location, and enrollment number:
* You will need to send us supporting documentation
to establish and substantiate your claim.

 yes       no

 
Are you a descendant of a Native American Indian person?

If so, we need to know the ancestor's name,
tribal affiliation, your relationship, birthdate,
birth location, and enrollment number, if available:
* You will need to send us a genealogy and supporting
documentation to establish and substantiate your claim.

 yes       no

 
Are you a member of a Native American Indian organization 
(not a state- or federally-recognized tribe)?

If so, the organization's name, location,
and your position in the organization:

 yes       no

3. Educational Background
last middle or junior high school name:
address:
graduation year:
 
last high school name:
address:
graduation year:

Did you graduate from high school?
yes       no

If no, have you received a GED?
yes       no

 
college / vo-tech school name:
address:
degree & field:
graduation year:

Did you graduate from vo-tech or college?
yes       no

 
graduate school name:
address:
degree & field:
graduation year:

Did you graduate from graduate school?
yes       no

4. Military Service
branch:
duty stations:
MOS/Rate & description:
active duty dates:
rank at discharge: commendations:
type of discharge:
Did you receive an honorable discharge? yes       no

5. Extracurricular Activities
organizational membership/s:

organizations' names, addresses,
and your position in the organizations,

including a description of past and current Native American involvement, including Indian Affairs Commission, Indian Affairs Advisory Council, Native American Convention

6. Work History
current employer-1 name:
address:
your position:
employment date:
previous employer-2 name:
address:
your position:
employment dates:
previous employer-3 name:
address:
your position:
employment dates:
previous employer-4 name:
address:
your position:
employment dates:

7. Background Information
Commissioner appointments are to political positions in state government. As such we need to be able to assure
the state's representatives that they will not suffer any embarrassment as a result of their appointments.
TN Bureau of Investigation background checks of nominees may be requested at the discretion of
the Governor or Speakers of the House and/or Senate. So we need to ask:
Have you ever been convicted of a felony? yes       no             If yes, please explain:
Is there any additional background information you would like to share? yes       no             If yes, please explain:

8. Personal References
TNNAC will not share references' contact information.
reference 1
name:
address:
phone number/s:
relationship:
reference 2
name:
address:
phone number/s:
relationship:
reference 3
name:
address:
phone number/s:
relationship:

9. Your Personal Statement
Description of why you would be
a suitable commissioner:


Please make your statement
at least 100 words long.
All statements will be checked for accuracy.

10. The End
I affirm that the information submitted in this form is true and accurate to the best of my knowledge.
I understand that any false or misleading information will disqualify me from this TNNAC election process.

signature (type your full name):

date:

All nomineess must be nominated and seconded by at least two (2) Tennessee residents of Native American descent, with their signatures, printed names, addresses, phone numbers, email addresses, tribal ancestry and state- or federally-recognized tribal status, and any membership in a Native American organization. (TNNAC Bylaws, Section 4.b)
nominator 1:     name
address
phone numbers
email
tribal ancestry
Native American organizational membership
nominator 2:     name
address
phone numbers
email
tribal ancestry
Native American organizational membership

Remember: after completing this form, please send
  1. hard copies of your two (2) proofs of Tennessee residence (a utility bill [gas, water, electric, phone] with your name and home address in Tennessee on it and a copy of your state's drivers license [black-out any SSN or ID number]) and
  2. your Native American Indian genealogy data and supporting documentation (birth, marriage, death certificates, enrollment card copies, roll number copies, etc.), or tribal enrollment information, and
  3. a recent photograph (analog or digital) of the nominee, and
  4. All nominations must be made and seconded by at least two (2) Tennessee residents of Native American descent, with their signatures, printed names, addresses, phone numbers, email addresses, tribal ancestry and state- or federally-recognized tribal status, and any membership in a Native American organization.
    You will also need to submit a list of at least twenty-one (21) names and signatures of registered Tennessee voters from your grand-division who support your nomination. Get a copy of the forms here: West TN, Middle TN, East TN.

    This information will be made available to the public via the TNNAC website, www.tnnac.org, and at the caucuses.

    to: TNNAC, box 1063, Chattanooga TN 37401.

    Any questions or problems with this form, please contact tom kunesh, 423. 624.3380.

    If you have a printed copy of this form, you need to fill it out
    online at www.tnnac.org/nominee-form-2003.html.
    (TNNAC has no paid staff to input candidate data.)

    thanks.

last updated: 18july03.tpk