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Sign Up

Ahmedabad Ophthalmological Society

Membership Application Form

All Fields are Mandatory Except Where It Is Mentioned as "Optional"

Primary Information

First Name

Middle Name

Last Name

Email (To Be Used for Login and Communication from AOS Portal)

Password *

Photo *

Birth Date

Age

Gender

Communication Details

Address

City

Pincode

Phone (H) (With STD Code e.g. 079 - 2xxxxxxx)

Phone (R) (With STD Code e.g. 079 - 2xxxxxxx)

Mobile (1)

Mobile (2) Optional

Preffered Mode of Communication

Educational / Qualification Details

Degree

Institute / University

Year

Joining Essentials

AOS - Reference Member Number

Please check this box to continue

I agree to receive the updates and promotional emails from organization

Membership will be activated only upon realisation of Payment and approval by the governing board of the society.
The membership fee will be decided in the Annual General Body Meeting from time to time for the succeeding period.
At present the life membership fee is Rs. 1000/- (Rupees One Thousand only) payable on enrolment.
The Patron, the Honorary Member and Ex-Officio Member will not be required to pay membership fees nor they will be eligible to vote or to contest in any election of the Society.

Bank Details

Account Name : Ahmedabad Ophthalmological Society

Account no : 393301010071685

IFSC Code : UBIN0539333

Bank Name : Union Bank

Branch Place : Vastrapur, Ahmedabad

Ahmedabad Ophthalmological Society

Reg. No. F / 7431 / Ahd. Dtd. 13-03-2000
Registered as a public trust Reg. No. Gu / 7586 / Ahd. Dtd. 13-03-2000 Registered as a society.

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