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Personal information

First name

Middle name

Surname (Grand Father’s Name)

Date of birth (European Calendar)

Sex

Marital Status

Nationality

No. of Children

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Place of birth

Region

Woreda

Country

Zone

Current Address

Country

Region

Zone

Woreda

Telephone-Land line

Mobile

P.O. Box.

E-mail

Skype

Work Experiance

WORK EXPERIENCE (If you have more than one please use "Add more form button" )

WORK EXPERIENCE (If you have more than one please use "Add more form button" )
From: To: Employer Postion: Place of work: Responsibility:

Education

Graduate study (PhD / MSc):

Graduate study (PhD / MSc):
Period (DD / MM / YYYY): From Period (DD / MM / YYYY):To Name of the University/ College providing the training: Country: Title of degree awarded: (attach) Upload requirements Thesis/Dissertation Title:

Under Graduate Study

Under Graduate Study
Period (DD / MM / YYYY): From Period (DD / MM / YYYY): To Name of the University/ College providing the training: Country: Title of degree awarded: (attach) Upload requirements Thesis/Dissertation Title:

Primary school:

Primary school:
Period (DD / MM / YYYY): From Period (DD / MM / YYYY): From Name of school: Country / Region:

Junior Secondary

Junior Secondary
Period (DD / MM / YYYY): From Period (DD / MM / YYYY): To: Name of school: Country / Region:

Secondary school

Secondary school
Period (DD / MM / YYYY): From Period (DD / MM / YYYY): From Name of school: Country / Region:

Other trainings attended

Other trainings attended
Period: From Period: To Title of training: Name of the institution(s) providing the training: Country / Place: Attach certificate Upload requirements

Personal skills and competences

Language skill: Rate as (Native, Excellent, Very good, good command, basic communication skill)

language	Read	Write	Speak
language

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Technical Skills and competences:

Carrer Interests

Government employment

Private Veterinary Practice

Academic environment

Research

NGOs and development work

Consultancy

Animal production

Others

Training ans Education interests

Veterinary research

Clinical practice

Animal production

Animal welfare

One Health

AMR

MSc / PhD

Membership Type

Regular

Cooperative

Lifetime member

Honorary member

Terms and conditions

I have carefully read the Ethiopian Veterinary Association constitution as amended at the meeting held from 19-20 June 1992, in Addis Ababa and I fully agree to be bound to the rules and regulations of the Association.
With this in mind, I apply to be registered as a

Terms and conditions

New member

Renewal of my membership

Since when you were a member of EVA (Year)

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