Joining as a new member

Indo-Pacific Academy of Forensic Odontology

Joining as a new member

You should fill the enrollment form and submit it to the Treasurer Dr. Rajinder Singh Chandel, Associate Professor, Department of forensic Science, Punjabi University, Patiala, 147002, Punjab, India along with a bank draft of Rs. 2000/- in the name of Indo Pacific Academy of forensic Odontology Payable at Patiala.

 

INDO PACIFIC ACADEMY OF FORENSIC ODONTOLOGY

Application form for membership

Membership:      Life Membership                                                                            Annual Membership

Name ……………………………………………………………………………………………

Father’s Name/Husband Name ………………………………………………………..      Paste passport

Age ……………………………………………………………………………………………….   size photograph

Sex ……………………………………………………………………………………………….

Qualifications ………………………………………………………………………………..

Designation …………………………………………………………………………………..

Number of Publications……………………………………………………………………..

Office Address  …………………………………………………………………………………………………………………..

Phone number  …………………………………………………………………………………………………………………..

Residential Address  ……………………………………………………………………………………………………………

Phone number …………………………………………………………………………………………………………………..

Email address  ……………………………………………………………………………………………………………………

 

 

 

Signature

Place

Date

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Approved                                                                            Membership Number

 

Treasurer

 

President