APPLICATION FOR MEMBERSHIP

Any queries regarding Online Registration Technical Assistance, Please contact 0824 – 4252005 ( 9:00 AM – 6:00 PM Working days)
Any queries regarding Registration Fee, Membership Number etc.

Step 1 : SBI Collect
  1. 1. Visit the SBI Collect Click Here and Fill in the details.
  2. 2. For SBI Collect help file Click Here
  3. 3. Select the Payment option (UPI, NEFT, Credit Card, RuPay etc) and proceed with the payment.
  4. 4. After successful payment, Download the payment receipt and collect the SBICollect Txn Number from SMS.
Step 2 : APPLICATION FOR MEMBERSHIP
  1. 1. Fill your membership details with Mode of Payment as SBI Collect. Upload the payment receipt and enter the SBICollect Txn Number.
  2. 2. Be ready with scan copy BDS/MDS Certificate & your Photo.
  3. 3. This application form filling is mandatory to get the Membership Number.


'*' Fields are Mandatory
Membership Type :





 

* Select Prefix :

* Name :

* Name of College/Place of Work :

* Photo : (Photo Size Max 1MB) (Only .jpg, .jpeg, .png files allowed)



* Upload Scanned Copy of Payment Receipt : (File Size Max 1MB) (Only .jpg, .jpeg, .png, .pdf files allowed)



* Qualification :
Certificate :
* Graduadtion (BDS) : (File Size Max 1MB) (Only .jpg, .jpeg, .png, .pdf files allowed)



* Post Graduadtion (MDS) : (File Size Max 1MB) (Only .jpg, .jpeg, .png, .pdf files allowed)



Others : (File Size Max 1MB) (Only .jpg, .jpeg, .png, .pdf files allowed)




* Gender :

* DOB :
 

* Correspondence Address :

* Pincode :

* Country :

* Select State :

* Correspondence Mobile Number [10 digit] :

* Correspondence Fax Number :

* Correspondence Email ID :
   

Residence Address :

Pincode :

Country :

Select State :


Residence Contact Number :

Dental Council Registration Number :

Name of the State Dental Council :

Membership with other Professional Associations :

* Select your state for State Membership :

To View Membership Amount Click here :

Payment Mode :

Payment Details
* Amount Paid :

* Date :


* Transaction Number :

Please click on Submit button

Key Contact

President
DR. VEERABAHU. M.
Phone : +91 9840141824
Email : president@aomsi.com
Hon. General Secretary
DR. PRITHAM N SHETTY
Phone : +91 9008400200
Email : secretary@aomsi.com
Hon. Treasurer
DR. PRAMOD SUBASH
Phone: +91 8281022999
Email: treasurer@aomsi.com
Hon. Editor
DR. RISHI BALI
Phone : +91 9315396704
EmaI: editor@aomsi.com

Payment Information

SBI Collect

  1. 1. Visit the SBI Collect Click Here and Fill in the details.
  2.      For SBI Collect help file Click Here
  3. 2. Select the Payment option (UPI, NEFT, Credit Card, RuPay etc) and proceed with the payment.
  4. 3. After successful payment, Download the payment receipt and collect the SBICollect Txn Number from SMS.
  5. 4. Visit the AOMSI website, Fill your membership details with Mode of Payment as SBI Collect. Upload the payment receipt and enter the SBICollect Txn Number.