DOWNLOAD POS Membership Form 

Procedure:

1. Please download the form at the above link, take a printout, fill in the details, put the date and attach your photo.
2. Make payment of Membership fees (Rs. 3000) HERE
3. Keep the following documents ready : A. MBBS certificate B. Post Graduation Certificate C. MMC/MCI registration certificate and D. Receipt of payment transaction.
4. Please send the duly filled membership form along with above 4 documents either by post/courier or deposit physically to the POS secretariat at the address given here. Dr. Piyush Bansal, Bansal Vision Institute, 1st floor, Connaught Plaza, Sadhu Vaswani Road, Opposite GPO, Pune 411001.
   Contact number: 020 26123456, 97642 49690.
5. For any queries please contact Dr. Piyush Bansal, Hon. Secretary (2022-23) on secpospune@gmail.com or at any of the above numbers.
6. Please note that your POS Membership will be ratified in the AGM in due course..

Thanks & Regards,

Dr. Piyush Bansal
Hon. Secretary POS (2022-23)

Tel: +91 77989 88676. Personal Email: drpiyushbansal@gmail.com

Email: *

Password: *

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Password Strength: Too Short

Title:

Dr. Mr. Mrs. Ms. Smt.

POS Membership Number:

First Name: *

Last Name: *

Sex:

Male

Female

Email Id: *

Designation Year:

Please enter current year Ex : 2018

Membership Type:

RegularAssociateOther

Designation:

POS MemberHon. PresidentHon. SecretaryHon. TreasurerImm. Past PresidentImm. Past SecretaryHon. Vice PresidentHon. Jt. SecretaryHon. Jt. TreasurerManaging CommitteeEditor POSTERCo-Opted MemberScientific CommitteeMedicolegal and ethics committeeAdvisory CommitteePatrons

Voting Right:

Yes

No

Achievement:

Degrees:

Allopathy / Others:

Allopathy

Clinic Landline Number:

Residence Landline Number:

Mobile Number: *

WhatsApp Number:

MMC Registration Number:

Clinic Address:

City:

State:

Pin Code:

Residence Address:

Preferred Postal Address:

Clinic

Residential

Date Of Birth:

Marriage Anniversary:

Upload ICard Size Photo:

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