Registration – W.C.C.R.M. Audio-Electronic and Electrical Engineering Department, Worldwide

SPONSOR

NAME OF DIOCESAN PASTOR

Name of Curent Pastor in Charge of Diocesan

DIOCESE

Name of Diocese

DIOCESAN PASTOR CONTACT NUMBER

Phone Number of Pastor in Charge of Diocesan

PARISH/DISTRICT PASTOR CONTACT NUMBER

Example: Pastor John Odeh / 080900000000

NAME OF DIOCESE / DISTRICT/PARISH WITH FELLOWSHIP ADDRESS

Name / Traceable Address of Location currently identified or working

DATE JOINED WCCRM

DATE JOINED DEPARTMENT

First Name

Last Name

Profession

My current Job

Skill

technical skill

Phone Number

MARITAL STATUS

Birthday

Date of Birth

Language(s)

Separate by comma

Current Residential Address

including Country and State

PLACE/STATE/COUNTRY OF BIRTH

COUNTRY/STATE/L.G.A. OF ORIGIN

POPULAR FAMILY NAME IN COMMUNITY

OCCUPATION

OCCUPATIONAL STATUS

DISABILITIES

OTHER DISABILITIES EXPLANATION

IF YOU HAVE SELECTED "YES (OTHERS)" IN DISABILITIES PLEASE KINDLY SPECIFY

RELATED EQUIPMENT(S) PROFESSIONALISM

HOW GOOD I CAN BE ON REGULAR RELATED EQUIPMENT(S)

User Name

E-mail

Password

Password Confirmation

Nickname