Membership If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required MEMBER INFORMATION First Name - ሽምካ * Last Name - ሽም ኣቦኻ * Age Group - ዕድመ * 17-2525-50Over 50 Marital Status * SingleMarriedDivorced Spouse, if married Anniversary Date, if married (e.g. August 12) MAILING ADDRESS Mailing Address * City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Post Code * Phone * Email FAMILY INFORMATION Please provide the following information, even if you are single, we need this for household membership information for our Church. Household Name (Enda Ato/Ekele) Names of children becoming members with you, if any: Name list VOLUNTEER If you would like to serve at the Church, please let us know. These are my gifts, talent and interests (Please check all that apply). These are my Gifts, Talents and Interests (Please check all that you would be willing to help) Childcare Computers/Graphic Design/Photography/Audio Visual/Electrical Cooking, baking, or serving food Event Planner Fundraising Financial Church ground maintenance Public Relations Music or Instrument Teaching/Mentoring Usher Visiting or caring for others Writing Others 3 + 20 * We thank you for taking the time to fill out this forms. God bless you.