NSSI Membership Application Form

Neurological Surgeons' Society of India

Application for Membership

[forminator_form id="985"]

Payment can also be made by NEFT/Bank Transfer/IMPS. The Details 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

    Personal Information
    Address
    Qualification
    1. MBBS: Mandatory Qualification
    MCH
    DNB
    OTHERS
    APPOINTMENT
    AREA OF EXPERTISE
    Membership Type *

    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.

    PAYMENT DETAILS
    UPLOAD DOCUMENTS
    PROPOSED BY: Mandatory Field
    SECONDED BY: Mandatory Field
    For Office Use
    1. Membership No NSSI -

      Receipt No................

      Date......................

    2. Approved


      Secretary

      NSSI



    3. Treasurer

      NSSI

    DETAIL OF PAYMENT
    1. Life Member Rs.15000/- in one installment, Associate Member (DNB,MCh Students) 15000/- in one installment (Life Membership Reclassified after producing Degree/Diplome of MCh/DNB) Allied Member 10000/- in one installment, Foreign Members 400 USD to be drawn in favor of Neurological Surgeons Society of India. Dully filled membership application along with fee is to be sent to:-Dr. R.S.Mittal 105 Virndavan Vihar Colony Near Shyam Nagar Police Station Nirman Nagar Ajmer Road Jaipur 302019 Phone:-0141-2810950,+919414244866(M) email dr_mittal@hotmail.com, nssi.india@gmail.com

    NSSI Qrcode

    Name of Bank: ICICI Bank
    Opposite S.M.S Hospital, SAWAI RAM SINGH ROAD, Jaipur
    A. /C HOLDER – NEUROLOGICAL SURGEONS SOCIETY OF INDIA
    A/C No –  675001700384
    IFSC CODE –  ICIC0006750
    MICR CODE   – 302229016