Please enter your first and last name

Your complete mailing address

A contact number you can be reached at

Your Snoqualmie Tribe enrollment number

Please select the method we use to contact you

Please choose the type of payment you are requesting

Please select the type of benefit requested

Enter the benefit amount you are requested

By checking the box you understand: I certify the information contained above is complete and accurate to the best of my knowledge. I understand that Tribe reserves the right to pursue any available remedies at law and/or equity to recover any misused funds. I agree that the Emergency Assistance Program may contact other tribal programs for pertinent information as it applies to this application. I understand that if I have requested an item that is considered a taxable expense I may be issued a 1099-MISC form at the end of the year. Additional program details can be located on the Emergency Assistance Application that can be found on the Snoqualmie Tribe’s website.