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Ethiopian Muslims Relief & Development Association

Membership Registration Form

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Volunteers to be Permanent Member Associate Member

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Name Sex Age
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Nationality
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Address Nation Region District
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City
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Postal Address Tel E-mail
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Qualification (Profession) Occupation
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Professional & other contribution
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Profession
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In cash Birr
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In Kind (Wokf)
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Your Contribution in detail

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Donation Collection: (March, June, September, December)

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Applied Signature Date

Your Expection

Secretarial Use
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Registration Membership Type
W . T S T
Board Chair Signature Date

.45 6X ; +Y + U 7515
6X + 6X 251-115520803
7 U V 6X Z 7 6X 251-115519152
Address: P. O. Box Tel. Fax:
e-mail - emrda@ethionet.et Web site: www.emrda.org