Membership Application form (2)

Welcome to Elibat Charitable Organization
Name

First nameLast name
Date of Birth

MonthDayYear
Date
Address

Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country
Nationality
First name
Last name
Address
Phone number I.
Alternative number 2.
Organization/institution
Title/ if student study level and field
- Are you a member of any organization or clubs?
If yes, please write the organizations/clubs name
- Tell us about yourself and why you want to become a member of Elibat Charitable Organization in less than 200 words

Activities/trainings you are interested in: leadership training Soft skill training Self development training

Cnetworking and communication events and platforms fundraising activities

How did you hear about us? friends

Select your membership type: individual

- Select the membership level you would like to hold:

Level I- Blue membership 150 monthly/1,800 ETB annually (monthly program and networking opportunity with the city's influencers, entrepreneurs and seasoned professionals
( Level 2- Golden membership 250 monthly/3000 ETB annually (monthly program and networking opportunities with the city's influencers, entrepreneurs and seasoned professionals and weekend events in addition to trainings and forums for professional and personal development. NB: It is transferable, another person can attend on your behalf

Level 3- Silver membership 1,000 per month/12,000 ETB annually (for organizations or corporations ONLY) = Level 4- Student membership 50 monthly/600 ETB annually (monthly program and networking opportunity with the city's influencers, entrepreneurs and seasoned professionals - I am willing to become Elibat's member anc willing to pay membership fee in a: trimestral/arrangement biannual arrangement annual/ lump sum arrangement If you require any further clarification/information please refer to, Elibat's website or

Applicant's signature declare that all the information given on this form is true and correct. I also accept membership into Elibat Charitable Organization and agree to abide by their policies of good character and morality.
Elibat's Employee Name
Signature

Clear
Date

MonthDayYear
Date
Member number
Should be Empty: