REGISTRATION DETAILS

Type of Membership: (Please Select)
1. Life Member -  (Rs.5000/-) Open to all medical professionals holding a recognized post graduate degree in the concerned specialty.
2. Overseas Life Members - (Rs. 5000) Open to all medical professionals holding a recognized post graduate degree in the concerned specialty of National Boards.
3. Life Associate Member -  (Rs.5000/-) Open to all paramedical professionals involved in the specialty.


Submission of Registration form online is mandatory .For payment of registration fees applying members can pay fees online and also have the option of paying via Cheque on the postal address. Please understand the details of both as mentioned below:

1. Online Payment System :
  • • Submit Online Registration form
  • • Ensure to upload Mandatory Self attested documents accurately i.e. Highest Medical qualification certificate, Medical Council Registration Certificate, Curriculum Vitae and Photograph. Incomplete forms will be rejected .
  • • Make Online Payment.
  • • Check your email and click on the verification link.
  • • Receipt will be made available to you after due confirmation of Payment. This may take some time.
2. Offline Payment:
  • a.) Submit Registration form online and Payment by Cheque.

    • • Submit Online Registration form
    • • Upload Mandatory Self attested documents i.e. Highest Medical qualification certificate, Medical Council Registration Certificate, Curriculum Vitae and Photograph
    • • Check your email and click on the verification link.
    • • Download attachment received in Verification email. Take a print out and send along with the cheque to the office address.
    • • Make your cheque payment as per detailed instructions given below.
    • • Receipt will be made available to you after due confirmation of Payment. This may take some time

  • b.) Complete Offline Registration and Payment System

    • • Download Registration form
    • • Please send the form, self-attested medical / dental council qualification and registration certificates, curriculum vitae and photograph via email to the Secretary Dr.Prathamesh S. Pai (fhno.office@gmail.com)
    • • Make your payment as per below instruction
    • • Receipt will be made available to you after due confirmation of Payment.
    • • Make your cheque payment as per detailed instructions given below.
    • • Receipt will be made available to you after due confirmation of Payment. This may take some time
    Please make your payment to “ Foundation for Head & Neck Oncology” by Bank Draft / Cheque (MICR)/ Demand Draft (payable at Bengaluru) .Please ensure to mention below details, Bank Draft /DD/Cheque details: Cheque no: _______ Date ___________

    Please send the payment to the Treasurer
    Dr.Vikram D. Kekatpure
    009 RS Greenwoods,
    Hosur road, Bommasandra
    Bangalore 560099

    Existing members : You are requested to go through your details on the website and kindly verify your details. For any update/correction you need to just fill the Registration form online with accurate details, documents and photograph .Kindly enter your lifetime membership number accurately while filling form. The details will be updated automatically .




    Click to download registration form

    REGISTRATION FORM

         




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