NATIONAL NEXT OF KIN REGISTRY REGISTRATION FORM
Mail to: NOKR Inc.
2020 Pennsylvania Ave. NW # 908
Washington, DC 20006

PLEASE PRINT INFORMATION BELOW
www.nokr.org


Individual You Are Registering (Required Information *)


Name First & Last


_______________________________________________
*

 

Address


_______________________________________________ *                
If homeless, place "Homeless" on this line

 


City


_________________________
State/Province __________ *

 


Zip Code

__________________ *

 


Optional

_______________________________________________

 


Age Optional

__________________

 


Photo is Optional

Mail to the address above NOKR


Additional information could be identifying factors such as, tattoos, mole, missing teeth, family Dentist etc.

Additional Information
Optional

___________________________________________________

___________________________________________________

 

 

 

 

The Next Of Kin listed below is my * Check One Please select one below indicating your relationship to your next of kin.  If no family is available select (Other) and indicate relationship i.e.. Neighbor, boy or girl friend etc.

Spouse >      Mother >      Father >     Sister >      Brother >     Son >     Daughter >     Aunt >   

Uncle >     Niece >     Nephew >     Cousin >     In-Law >        Other
_______________________

 

 

Next Of Kin Information (Required Information *)

 


Name First & Last


_______________________________________________
*

 


Address


_______________________________________________
*

 


City


_________________________
State/Province __________ *

 


Zip Code

__________________ *

 

Telephone 
Optional

_______________________________________________

 


Additional
Information
Optional

___________________________________________________

___________________________________________________

 

 

           

Add any additional contact information in the area above. Example, email, other relatives to contact, etc.