Gambella Education Bureau, Gambella Educational media

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 Student Information Study Program: Regular program      Private program  Name: _____________________________ Father Name: ________________________________________________ Grand Father Name: __________________________________________ Nationality: ____Ethiopian______ Other ______________________ Date of Birth (Eth. Calendar):  Date _______Month _____ YEAR _______ Gender:  Male  Female Region ___________________ Zone _____________________  Woreda ________________ Kebele _______________ School _______________________________________________________ Disability:   None  Handicap  Deaf  Other Visual Impairment  None    One Eye  Both Eye Phone Number_______________ Email: _____________________ Study Stream  Natural Science  Social Science Relative Information Relation Type  ( Parent  Adoptive Parent  Grand Parent  Guardian  Parents Sibling) Name _______________________________________________________ Father Name ____________________