Membership Form

Membership Application Form

Please complete the form below to apply for a Membership Application Form with us. To qualify for membership the following requirements need to be fulfilled: Education: Bsc or above Annual Payement 240 birr per year for individual membership Annual Payement 3000 birr per year for institutional membership

Personal Information

Full Name *

Name of Institution (ONLY FOR Institution)

Photo (For Individual Membership only)

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Phone Number *

Email *

Fax

City *

Address *

Postal / Zip Code

Country *

Full Name (Contact Person for Institutions)

Institutional Affiliation

Area of Specialization

Department

Residential address: country

Residential address: Region

Residential address:Town

Residential address:P.O.Box

Residential address:Tel

Mobile Phone

Work address: Country

Work address: Region

Work address: Town

Work address: P.O.Box

Work address: Te

Mobile Phone

Position

Nationality *

Sex *

Male

Female

Education level

MBA

PHD

Subject Studied

Experiences in Different Positions (For Individuals) /Experiences in Social Development & Research (For Instutsions)

Experiences I

Experiences II

Experiences III

Three important short-term training (for individuals) / Recent Research Topics /Social Development Intervention Program

Short Term Training I

Short Term Training II

Membership Type *

Methods of Payment *

Professional Contribution for the Association

I Agree *

I the undersigned has given true information above and applying to be member of ESSSWA

Attach credential

Upload Files (Files must be less than 5 MB, Allowed file types: txt pdf doc docx. *

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Attach Bank Slip *

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Income Tax Planning