Register – Ethiopian Veterinary Association

Membership Registration Form

Personal Information

First Name*

Middle Name

Last Name*

Gender

Birth Date

Phone Number

E-mail Address*

Username*

Password*

Confirm Password*

Address

Education & Work Information

Highest Level of Education Complete

Highest Level of Education Complete (Other)

Field of Study

Upload DVM File*

Current Employment Status

Organization/Company Name

Industry/Field of Work

Current Job Title

Membership Information

Membership Type

Upload membership fee receipt*

Are you going to participate on 50th anniversary and 37th annual conference?*

Social Media Accounts

WhatsApp number

Only fill in if you are not human