Application Form

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Membership Requirements

1) All Ethiopians and any person of Ethiopian heritage or their spouse are eligible to be members of EEMAA.

2) Membership shall be limited to residents of the New York metropolitan area at the time they join EEMAA..

Click here to download the membership application form or Fill out the online form below.

New Members’ Application Requirement Guide

❑ All Ethiopians and any person of Ethiopian heritage or their spouse are eligible to be members of EEMAA.

❑ Membership shall be limited to residents of the New York metropolitan area at the time they join EEMAA

❑All applicants to Edir should apply in person, husband & wife if married, at the in-person Board meeting.

❑ If the Board meeting is held virtually, the applicant, both husband and wife if married must appear at the virtual meeting.

❑ All applicants to Edir should submit the following required documents at the in-person Board meeting or by mail if the Board meeting is held virtually.

Required Documents

❑ Completed Application Form.

❑ Driver’s license or City ID with Tri-State address to verify legal residency.

❑ Birth certificate for dependent children under age 22.

❑ Birth Certificate for applicants age 22 to 35.

❑ Marriage certificate for married couples.

❑ Application fees.

Dues & Fees

❑ One time membership fee for couples and individuals over 35 years - $1000

❑ One time membership fee for 22 years to 35 years - $150

❑ One time membership fee for members dependent parent - $500

❑ Additional payment to the one-time membership fee for dependents under 22 years - $75

❑ Annual administrative fee - $60 - All applicants pay this fee.

የኢትዮጵያውያን እድር የመረዳጃ ማህበር በኒውዮርክ ኢንክ

Ethiopian Edir Mutual Assistance Association in New York Inc.

450 Lexington Ave. 4th Floor

C/o WeWork

New York, NY 10017

ID#______

Application for Membership

Applicant Full Name *

First

Last

Spouse

Permanent Residence Address *

Address Line 1

City

State

Zip Code

Home Phone

Office Tel.

Cell Phone No. *

Email Address *

Names of Children under 22 years of age and Date of Birth

1. Name

Date of Birth

2 Name

Date of Birth (copy)

3. Name

3. Date of Birth

4 Name

4. Date of Birth

(proof of age is required with the membership application)

Death Beneficiary

Full Name *

Relationship to applicant *

Address *

Full Address of the Beneficiary

Beneficiary's Phone # *

Next of Kin

In the absence of designated beneficiary, next of kin will be contacted.

Full Name of next of kin *

Phone # *

Agreement

As a member, I fully agree and abide by the rules and regulations of EEMAA. I hereby apply for membership and pledge to fully adhere to the Administrative Regulations and Bylaws of EEMAA. I also certify that the information provided above is true and correct.

Do you understand and agree to the terms listed above? *

Yes, I understand and agree to the terms listed above.

Applicant’s Signature

Date / Time

Authorized EEMAA’s Official Signature(For office use)

for office use

Date

For EEMAA’s Use: Accepted__ Not Accepted __ (see attached) Initial_____ Date________________

Please attach a photocopy of your documents(pdf word, .png, .gif, .jpg)

Click or drag a file to this area to upload.

Payment - More than one Checkboxes are required *

One time Couples or Individuals over 35 yrs - $ 1,000.00
One time membership fee for 22 years to 35 years - $ 150.00
One-time membership fee for dependents under 22 years /child - $ 75.00
Annual administrative fee - $60 - All applicants pay this fee - $ 60.00

Total membership application Fee

$ 0.00

Stripe Credit Card *

የኢትዮጵያውያን እድር የመረዳጃ ማህበር በኒውዮርክ ኢንክ

Ethiopian Edir Mutual Assistance in New York Inc.