Cancer care Ethiopia CCE
 
 
 
 
 
 
 
 
 

+251938888880

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Cancer Care Ethiopia (CCE) ካንሰር ኬር ኢትዮጵያ Membership Registration Form የአባልነት መመዝገቢያ ፎርም

 
 

Full Name/ሙሉ ስም:

 

Sex/ፆታ:

 

Age/እድሜ:

 

Place of work/የመስሪያ ቤቱ ስም:

 

Region/ክልል:

 

Sub-city/ክፍለ ከተማ:

 

Kebele/ቀበሌ:

 

House number/የቤት ቁጥር :

 

Phone number:

 

email:

 

country:

 

city / state:

 

address:

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Membership fee monthly (Birr/USD): ወርሃዊ ክፍያ (በብር/በዶላር)

 
 

Individual member/ለግለሰብ:

 

Corporate member/ ለተቋም:

 

Date/ቀን

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

if you want to contribute in other way

 
 

Full Name/ሙሉ ስም:

 

email:

 

Message: