Membership Form

LIFE MEMBERSHIP (INDIVIDUAL)

Qualification :


Life Membership fee of Rs 1000/- paid through Cash Receipt / Cheque / DD No. Date
Life Membership for NRI-Working outside India is 5000/- Payment Reference No. Date

To
The General Secretary,
Indian Confederation of Medical Laboratory Science (ICMLS)

Dear Sir,
I wish to join the INDIAN CONFEDERATION OF MEDICAL LABORATORY SCIENCE (ICMLS) as a Member. I am hereby paying Rs. 1000/- as Life Membership Fee/Rs 5000/- as NRI Membership fee (Working outside India) in Cash/ DD/ Cheque.

I hereby declare that I shall abide by the rules and regulations of ICMLS and shall try my best to fulfill the aims and objectives of the ICMLS.