Membership / የአባልነት መመዝገቢያ
Frist Name/ ስም
*
Last Name
*
Email Address/ ኢሜል አድራሻ
*
Gender
*
Male
Female
Prefer Not to say
Phone Number/ ስልክ ቁጥር
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city
State
Country
Full Address/ ሙሉ አድራሻ
Healthcare Professional?
Select
Yes
No
Degree/Diploma / የተመረቁበት ዲግሪ
Membership Type
Full Member - Diaspora ($200/Year)
Associate - Diaspora ($100/Year)
Institutional - Diaspora ($1,000/Year)
Full Memeber - Ethiopia (200 ETB/Year)
Associate - Ethiopia (100 ETB/Year)
Institutional - Ethiopia (5,000 ETB/Year)
Username
Password
I confirm that all the information provided is correct.
Total ETB
Please make your membership payment to the designated bank account and submit a copy of your payment confirmation receipt to info@eotma.org.
Total $
0.00
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