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Online Registration

Maharashtra Orthopaedic Association Application for Life Membership

To,

The Hon. Secretary cum Treasurer


Maharashtra Orthopaedic Association



Dr. PRAKASH SIGEDAR,



SIGEDAR HOSPITAL,, near municipal council, railwaystation-chaman road Jalna-431203


Tel. 02482-235773 



Email : psigedar@rediffmail.com


Website : www.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

Maharashtra Orthopaedic Association Application for Life Membership

Upload Signature of proposed life member
Upload Signature Seconded by Life Member
IOA Member
Upload Signature of Applicant
Upload your passport size photograph
Upload your Qualification Certificates (All doc. in 1 pdf format)

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.3000/-

Bank Details

A/C No.: 34314570701 | Name: Maharashtra orthopaedic Association | IFSC.: SBINOO20320
MOACON 2019
Academic Section