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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. Visit the SBI Collect
Click Here
and Fill in the details.
2. For SBI Collect help file
Click Here
3. Select the Payment option (UPI, NEFT, Credit Card, RuPay etc) and proceed with the payment.
4. After successful payment, Download the payment receipt and collect the SBICollect Txn Number from SMS.
Step 2 : APPLICATION FOR MEMBERSHIP
1. Fill your membership details with Mode of Payment as SBI Collect. Upload the payment receipt and enter the SBICollect Txn Number.
2. Be ready with scan copy BDS/MDS Certificate & your Photo.
3. This application form filling is mandatory to get the Membership Number.
'*' Fields are Mandatory
Membership Type :
LIFE MEMBER
STUDENT LIFE MEMBER
ASSOCIATE LIFE MEMBER
ASSOCIATE LIFE MEMBER (FOR SAARC)
*
Select Prefix :
DR.
PROF.
*
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 :
Male
Female
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DOB :
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Address :
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Pincode :
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Country :
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Oman
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Vietnam
Yemen
*
Select State :
--Select--
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar and Jharkhand
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli
Daman and Diu
Delhi NCR
Goa
Gujarat
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Jammu and Kashmir
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
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Manipur
Meghalaya
Mizoram
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Orissa
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Punjab
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Sikkim
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Tripura
Uttar Pradesh
Uttarakhand
West Bengal
*
Mobile Number [10 digit] :
*
Fax Number :
*
Email ID :
Residence Address :
Pincode :
Country :
Afghanistan
Armenia
Azerbaijan
Bahrain
Bangladesh
Bhutan
Brunei
Burma
Cambodia
China
East Timor
Georgia
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Macau
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Papua New Guinea
Philippines
Qatar
Taiwan
Russia
Saudi Arabia
Sri Lanka
Syria
Tajikistan
Thailand
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Select State :
--Select--
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar and Jharkhand
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli
Daman and Diu
Delhi NCR
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Puducherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
Residence Contact Number :
Dental Council Registration Number :
Name of the State Dental Council :
Membership with other Professional Associations :
*
Select your state for State Membership :
--Select--
Andra Pradesh
Bihar and Jharkhand
Chhattisgarh
Defence
Delhi NCR
Goa
Gujarath
Haryana
Himachal Pradesh
Jammu and Kashmir
Karnataka
Kerala
Madhya Pradesh
Maharashtra
North East
Odisha
Other
Punjab
Rajasthan
Tamil Nadu
Telangana
Uttar Pradesh
Uttrakhund
West Bengal
To View Membership Amount Click here :
View Membership Amount
SI.No
Category
Amount
Description
1
STUDENT LIFE MEMBER
Rs. 10620.00
for life time. Rs. 7500 National Membership Rs. 1500 state membership Rs.1620 GST
2
LIFE MEMBER
Rs. 10620.00
for life time. Rs.7500 National Membership Rs.1500 state membership Rs. 1620 GST
3
ASSOCIATE LIFE MEMBER
Rs. 9120.00
(Non Maxillofacial Surgeons only). Rs.7500 National Membership Rs.1620 GST
4
ASSOCIATE LIFE MEMBER (FOR SAARC)
Rs. 8850.00
for life time. Rs. 7500 National Membership Rs.1350 IGST
Payment Mode :
SBI Collect
Payment Details
*
Amount Paid :
*
Date :
*
Transaction Number :
The above furnished information are true to best of my knowledge . I here by agree to abide by the rules & Regulations of AOMSI.
Please click on Submit button
Key Contact
President
DR. BHAGAVANDAS RAI. A
Phone : +91 9828057442
Email : president@aomsi.com
Hon. General Secretary
DR. S GIRISH RAO
Email : secretary@aomsi.com
Hon. Treasurer
DR. RAJASHEKHAR. GADDIAPTI
Phone: +91 9000018128
Email: treasurer@aomsi.com
Hon. Editor
DR. AMIT DHAWAN
Phone : +91 9779081667
EmaI: editor@aomsi.com
Payment Information
SBI Collect
1. Visit the SBI Collect
Click Here
and Fill in the details.
For SBI Collect help file
Click Here
2. Select the Payment option (UPI, NEFT, Credit Card, RuPay etc) and proceed with the payment.
3. After successful payment, Download the payment receipt and collect the SBICollect Txn Number from SMS.
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.