Application for the Membership of
Andhra Pradesh Ophthalmic Society

Registered under Societies Act, Reg No. 192 of 2014

Filling of All Columns Essential

New Application Check Status
Applied forLife Member  
Member in Waiting  
Name (In Block Letters) :
Father's / Husband's Name :
Age :
Sex :
Date of Birth :
Native District :
Address (Present) :
Location :
City :
Pincode :
Address (Permanent) :
City :
Pincode :
Mobile :
Email :
Designation :
Academic Qualification :
Year of Passing MBBS :
Year of Joining in PG Ophthalmology / Diploma :
Note : Dear Doctor Please upload clear scan copies
Proposed by Dr
Seconded by Dr

Amount :
Declaration :I hereby declare that the above details are correct.I wish to be Life member.I have carefully read the instructions overleaf. Ishall abide by the Rules, Regulation & Bye-Laws of the Society as in force and any subsequent amendment(s) made from time to time.
I enclose Bank Draft No :
Dated :
Bank :
for Rs :
Date :

Note : If you face any problems during submission, please mail to # # with screen shot, we will do the needful, if your problem is not solved within 24 hrs please call # 7386045673 #


  1. The Society reserves all rights to accept or reject any application
  2. The form should be filled completely and take a print out after completion
  3. SMS and email will be sent to proposer and seconder (only APOS members). The application will go forward only after acceptance by proposer and seconder. (you can resend the sms/email to proposer or seconder if required.
  4. After uploading the required certificates – secretary’s office will check the certificates and activate payment button – you will receive a sms/email to pay the membership fees.
  5. Every new member will initially be provisionbally admitted and shall be deemed to have become a full member only after formal ratification by the general body and issue of ratification order by the society. Only then he or she will be eligible to vote or apply for any Fellowship/award propose or contest for any election of the society.
  6. Documents to be attached
    1. Copy of Degree (MBBS and postgraduation)
    2. Medical Council Registration Certificate
    3. ID Proof (adhar card/pan card/voter id/driving licence)
  7. After making the payment send the printed application form along with photocopies of the documents and payment receipt to the APOS secretary’s office