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If you need its interactive version, to fill and submit online, please click
on the 'Application'tab under 'User Menu' on the right side of the screen
again.
Oromo SOCIETY OF Science and Technology Membership Application |
Applicant Information |
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| Last Name | First | M.I. | Date | |||||||||||||||||
| Job Tittle | ||||||||||||||||||||
Mailing Address: Home Business |
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| Street Address | Apartment/Unit # | |||||||||||||||||||
| City | State | ZIP/Postal Code | ||||||||||||||||||
| Country | ||||||||||||||||||||
| Gender: Female Male | ||||||||||||||||||||
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Contact Information |
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| Home Phone | Business Phone | |||||||||||||||||||
| primary e-mail address | Secondary e-mail address | |||||||||||||||||||
| Education | ||||||||||||||||||||
| Diploma | Date | University/College | ||||||||||||||||||
| Degree (1) | Date | University/College | ||||||||||||||||||
| Degree (2) | Date | University/College | ||||||||||||||||||
| Degree (3) | Date | University/College | ||||||||||||||||||
| Majors | ||||||||||||||||||||
| Birth | ||||||||||||||||||||
| Date of birth | Month | Day | Year | |||||||||||||||||
| Place of birth | City | Region | Country | |||||||||||||||||
| Professional Experience in relevance to OSST | |
| Summary of the latest Professional Activity | |
| Wished field of contribution to OSST, if relevant | |
| How did you come to know of OSST | |
Applicant Signature Date