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Main line : 9185492880 Fax line : 9187581477 Jenks : 9185492484 Wetumka: 9185492880Date: ___ ___ ___Applicant Name:___Address: ___ Phone #: ___ ___ ___WagonerLength at address: ___mo/yrsAlternate #: ___ ___ ___Please circle the county you reside in: Tulsa800 Number: 18004821979CreekRogersOkfuskeeMayesOkmulgeeMuskogeeHughesMcIntoshSeminoleAre you a veteran? Yes ___ NO___ What tribe are you enrolled in? ___ Roll number: ___ How many dependent
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