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| "Finding Solutions and expanding opportunities" | |||||||
| Membership Application Form | |||||||
| NAME: ________________________________________SEX:____________________ | |||||||
| BUSINESS NAME: __________________ BUSINESS ID #:_____________________ | |||||||
| TYPE OF BUSINESS: ____________________________________________________ | |||||||
| BUSINESS ADDRESS:___________________________________________________ | |||||||
| CITY:__________________________ STATE:____________ ZIP_______________ | |||||||
| BUS. TEL:________________________ OTHER TEL: _________________________ | |||||||
| FAX:____________________________ EMAIL: ______________________________ | |||||||
COUNTRY OF RIGIN:__________________________________ |
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MEMBERSHIP FEE: |
Regular |
Associate |
ð 60.00/qtr |
ð 125.00/qtr |
ð 120.00/Semi-Annual |
ð 250.00/Semi-Annual |
ð 240.00/Annual |
ð 500.00/Annual |
| SIGNATURE:____________________________ DATE: ______________________________ | |||||||
| ð REGULAR MEMBER ð ASSOCIATE MEMBER ð OTHER | |||||||
| To Lead Economic Empowerment Initiative In the Ethiopian Diaspora | |||||||