"Tribal State Relations Group Registration Form" - Oklahoma

Tribal State Relations Group Registration Form is a legal document that was released by the Oklahoma Department of Mental Health and Substance Abuse Services - a government authority operating within Oklahoma.

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  • The latest edition currently provided by the Oklahoma Department of Mental Health and Substance Abuse Services;
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  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Oklahoma Department of Mental Health and Substance Abuse Services.

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Please use your browsers print function to print a copy of the form.
Tribal State Relations Group
(TSRG)
P
I
ERSONAL
NFORMATION
Name:
Tribal Affiliation:
Job Title:
Primary Phone
Secondary Phone:
Email address:
Affiliation:
Local Organization: _______________________________________________________
State Organization: _______________________________________________________
Tribal Organization: ______________________________________________________
Federal Organization: _____________________________________________________
Other: __________________________________________________________________
Please designate what you are able to contribute to the TSRG effort by checking the
appropriate boxes.
 Participate in developing a strategic action plan and logic model
Participate in development of cultural competent TSRG
Identify speakers that can educate the group on training needs, ie: capacity building
Offer a place to house the TSRG meetings and/or community-wide activities
Recruitment
Help build relationships between elected Tribal Leadership and State Leadership
________________________________________________________________________
Other
_______________________________________________________________________________
_______________________________________________________________________________
What do you hope to accomplish with your involvement with the Tribal State Relations
Group? __________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Please use your browsers print function to print a copy of the form.
Tribal State Relations Group
(TSRG)
P
I
ERSONAL
NFORMATION
Name:
Tribal Affiliation:
Job Title:
Primary Phone
Secondary Phone:
Email address:
Affiliation:
Local Organization: _______________________________________________________
State Organization: _______________________________________________________
Tribal Organization: ______________________________________________________
Federal Organization: _____________________________________________________
Other: __________________________________________________________________
Please designate what you are able to contribute to the TSRG effort by checking the
appropriate boxes.
 Participate in developing a strategic action plan and logic model
Participate in development of cultural competent TSRG
Identify speakers that can educate the group on training needs, ie: capacity building
Offer a place to house the TSRG meetings and/or community-wide activities
Recruitment
Help build relationships between elected Tribal Leadership and State Leadership
________________________________________________________________________
Other
_______________________________________________________________________________
_______________________________________________________________________________
What do you hope to accomplish with your involvement with the Tribal State Relations
Group? __________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________