NSSI Membership Application Form Neurological Surgeons Society of India (NSSI)

NEUROLOGICAL SURGEONS’ SOCIETY OF INDIA

Application for Membership

Name

Date Of Birth

Father’s Name

Permanent Mailing Address

Pincode

Phone No(With STD Code)

Mobile No.

Qualifications and Institute (Where Degree/Diploma obtain)

Appointments, Post and Experience *

Other interest

Membership

Life =>15000

Associate =>15000

Allied =>10000

Annual =>5000

1. A qualified neurosurgeon or a student of MCh/DNB neurosurgery below age of 40 yrs may apply for annual membership on prescribed form along with fee as Rs 5000/- to treasurer 15 days before commencement of annual conference of Society.

2. An annual member shall be entitle to participate in annual conference present scientific presentations in FREE SESSION ONLY ,and have no right to attend general body meetings of society.

3. An annual membership will be automatically expires after one year from availing annual membership.

4. An annual member shall not entitle to get/claim any fellowship, grants and official journal IJNS on the basis of annual membership.

5. If an annnual member wants to become a life/associate member he/she should apply on prescribed form. They will be get membership fee during their annual membership tenure only.

I understand terms and conditions of Annual Membership of Neurological Surgeons’ Society of India.

I Read And Accept

Amount

Bank

Place

Date

Signature of Applicant

Passport Size Photograph

Payment Can also be made by NEFT/Bank Transfer/IMPS The detail are as follows : Bank ICICI Bank Branch C Scheme Opposite SMS Hospital Jaipur Account Holder’s Name : Neurological Surgeons’ Society of India. Account No 675001700384 . MICR Code No 302229016. IFSC/RTGS ICIC0006750

Slide 1

Slide 2

slide3

Slide7

slide 4

slide 5

slide 6

NSSI Membership Application Form

NEUROLOGICAL SURGEONS’ SOCIETY OF INDIA