Maharashtra Orthopaedic Association Application for Life Membership

To,

The Hon. Secretary cum Treasurer

Maharashtra Orthopaedic Association 

Dr. Narayan Karne,

Dr. Karne Hospital, Near Laxmi Narayan Theatre, Satara Road, Pune 411043. Maharashatra. INDIA.

Tel. +91 9822036724  

Email : njkarne23@gmail.com

Website : https://mh.mahaortho.org/

Dear Sir,

I, the undersigned wish to join Maharashtra Orthopaedic Association as Life Member. My details are given below.

I am paying membership fees by online payment mode in next step after this form submission

My Personal Details are as follows

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Maharashtra Orthopaedic Association Application for Life Membership

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I agree to abide by the rules & regulations of Maharashtra Orthopaedic Association.

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Upload Signature of proposed life member

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Upload Signature Seconded by Life Member

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IOA Member

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Upload Signature of Applicant

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Upload your passport size photograph

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Upload your Qualification Certificates (All doc. in 1 pdf format)

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Important: Your membership is subject to ratification in the subsequent AGM of the Association during MOACON. Allotment of membership number will follow the ratification.

Note*: You will redirect to payment page after clicking submit button. Don't click back/refresh button on payment page. or Pay using bank transfer & note reference number. Our team will contact you within 24 Hrs after form submission.

Membership fees : Rs.5000/- ( Five Thousand Only ).

Bank Details

A/C No.: 34314570701 | Name: Maharashtra Orthopaedic Association | IFSC.: SBIN0001399, Branch code : 1399, Bank : State Bank of India, Tilak Road, Pune.

Membership Registration

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Online Registration

Maharashtra Orthopaedic Association Application for Life Membership

My Personal Details are as follows

Maharashtra Orthopaedic Association Application for Life Membership

Important: Your membership is subject to ratification in the subsequent AGM of the Association during MOACON. Allotment of membership number will follow the ratification.

Note*: You will redirect to payment page after clicking submit button. Don't click back/refresh button on payment page. or Pay using bank transfer & note reference number. Our team will contact you within 24 Hrs after form submission.

Bank Details