Monday, July 16, 2007

The Environmental Society of Ethiopia
“Sustainable Environment”

Membership Application Form
Background
Currently Ethiopia is faced with unprecedented environmental problems. The major environmental problem, however, is land degradation caused by inappropriate land use practices such as deforestation, over cultivation and overgrazing. Land degradation coupled with global climate change has led to disasters such as drought; floods etc. and has taken a heavy toll in different parts of the country. In this regard, the frequent droughts that hit the country and the recent catastrophic floods in Dire Dawa, South Omo, Awash, Amhara and Somali regions can be mentioned.

Pollution is also becoming apparent especially in urban areas. All these affect production and productivity and undermine the prospects for socioeconomic growth. Moreover, citizen’s right to live in a clean and healthy environment will be compromised. Providing solutions to these problems is beyond the capability of individuals and calls for concerted efforts by different stakeholders. Cognizant of this, some concerned environmental professionals decided to take the responsibility and establish the Environmental Society of Ethiopia (ESE) on September 22, 2006.

ESE is a non-political, non-profit making and non-religious professional society established as per the Civil Code and Regulation for Registration of Associations, Legal Notice No. 321/66 of Ethiopia. The Society shall have the following objectives:
To contribute to the environmental policy formulation capability and broadly to the environmental well-being of Ethiopia;
To promote the professional interests of its members;
To promote the study of environmental science in the country’s educational institutions;
To create awareness on environmental issues amongst the general public
To promote environmental research and assist in the dissemination of the findings of such research through, among others, publication of scientific journals, other documents etc.;
To provide fora for discussion of environmental issues;
To promote professional contacts between Ethiopian environmental professionals and their counterparts in other countries and;
To promote other objectives consistent with and supportive of the above objectives.

3. Membership
Full membership is open to all Ethiopians and non-Ethiopians who have a Degree and above in Environment and related fields like Forestry, Biology, Chemistry, Geology, Physics and consequently who wish to support the objectives of the ESE.
Associate membership is open to all Ethiopians and non-Ethiopians who have not fulfilled the requirements for full membership but who wish to support the objectives of the ESE and meets at least one of the following: a person professionally engaged in a field related to Environment or a person whose interest and commitment to Environmental sustainability has been demonstrated or certified by other members. They are regarded as an associate member.
Student membership is open to all Ethiopian and non-Ethiopian students in higher learning institutions majoring in Environment and related fields in undergraduate and graduate program.

I hereby apply for membership of The Environmental Society of Ethiopia.
(PLEASE WRITE IN BLOCK LETTERS)
Name _______ _______________________ ______________________ _________________________
Title First name Father’s name Grand father’s name
Nationality: _________________________

Sex: Male Female
4. Address
Institution/organization ______________________________________________________________________
City______________________________Country_________________________P.O.Box___________________
Telephone number: Office________________ Home__________________ E-mail__________________________
5. Membership fee
Membership Category
Registration fee
Membership fee
Residing in Ethiopia
Residing outside Ethiopia
Full member
5
25

Associate member
5
25

Student member
5
20








6. Academic Training
Name of school/college/university
Location
Period/year
Diploma/Degree obtained





















7. Area of Specialization


8. Professional Experience in Environment and Related fields
Institution/organization
Job title/position
Year of service (from-to)













Method of payment
(please check the box)
I send Birr _________ for registration and Birr _________ for membership by
A Check or money order made out to The Environmental Society of Ethiopia.
A Bank transfer payable to The Environmental Society of Ethiopia,
Account No. 0130422217200/491 Awash International Bank S.C. of Ethiopia, Aratkilo Branch,
Addis Ababa, Ethiopia.
A Postal money order made out to The Environmental Society of Ethiopia,
P.O. Box: 34793, Addis Ababa, Ethiopia.
You can pay in person.
The ESE’s office is located in the Science Faculty of Addis Ababa University (Arat KiloCampus), In the former Environmental Science Computer Center.










10. Agreement
I agree to restrict for my own personal use all publications to which I shall subscribe at member rates.I understand that membership dues are payable in advance unless my signed resignation is received by the Secretary one month before payments is due.

_______________ ______________________
Date of registration Signature of Applicant

FOR OFFICE USE ONLY: Status ____________________ Registration No. ______________

Registered by: __________________________ Signature: __________________

Checked by: ___________________________ Signature: __________________

Approved by: ___________________________ Signature: __________________


A copy of the receipt should be sent to the treasurer of ESE.

Send the completed membership form with your payment to:
The Secretariat, ESE
PO Box 34793
Addis Ababa,
ETHIOPIA
Phone: 251-91-101-5570/214-4187/113-4000/112-0221
251-11-646-0451
E-mail: ESEthiopia@yahoo.com

















The Environmental Society of Ethiopia

Institutional Membership Form*

Name of the Institution: _____________________________________________
City: ________________P.O.Box: __________Tel: _____________Fax: ___________
Product/Service Description: _______________________________________________
I, the under signed, confirm our institution's interest to be member of the Environmental Society of Ethiopia and pledge to fulfill the membership requirement including an annual contribution of Birr 150.00 (one hundred fifty).
____________________________ _________________________
Membership authorized by position/Title

___________________________ _________________________
Signature Date
(seal)
Membership Fee
- Registration fee - Annual Fee
Birr100.00 Birr 150.00
For Office Use Only:

Year Cash receipt No. Year Cash Receipt No.
_______ ______________ _______ ______________
_______ ______________ _______ ______________
_______ ______________ _______ ______________
_______ ______________ _______ ______________

A Bank transfer payable to Environmental Society of Ethiopia, Account No.0130422217200/491 Awash International Bank S.C. of Ethiopia, Aratkilo Branch, Addis Ababa, Ethiopia.

Remarks:
________________________________________________________________________________________________________________________________________________________________________________________________________________________

*Please fill-in this form and send the original to our society's office after making a copy of it for your record.

Send the completed membership form with your payment to:
The Secretariat, ESE
PO Box 34793
Addis Ababa,
ETHIOPIA
Phone: 251-91-101-5570/214-4187/113-4000/112-0221
251-11-646-0451
E-mail: esethiopia@yahoo.com