I) Membership Registration
Mr.
Miss.
Mrs.
Dr.
First Name
Surname
Date Of Birth
Marital Status
Email
Sex
Male
Female
Home Address
Postal Address
Phone Number
Occupation
Camp Name
In case of emergency during camp, please contact;
specify name here
Person to be contact with, specify his/her info;
Address
Telephone
Relationship with contact person:
Parent
Legal Guardian
Family Member
II) Language Proficiency: INDICATE WITH YES or NO
Language
Written Proficiency
Spoken Proficiency
III) School/ Institution Attended
Name Of School
Location
No. Of Years
Iv) Special Skills
Agric
Masonary
First Aid
Cooking
Teaching
V) Name Of guarantor
Guarantor Address
Telephone
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