Registration/

Register here to become a Member of IAOMR

'*' fields are mandatory

Any queries regarding Online Registration Technical Assistance, Please contact 0824 – 4252005 (10:00 AM – 6:00 PM Working days)

Please, Make sure you are ready with the soft copies of Photo ,BDS, MDS Certificate and Scanned Copy of Payment before you Register.

Note: Dear Postgraduate Students, Please, select Membership Type as ASSOCIATE LIFE MEMBER to proceed

Basic Details

Name*
 
Gender*
 
Blood Group*
 
Membership Type*
 
Contact Number*
 
Date of Birth*
 
Email ID*
Password*
 
Confirm Password*
   
Address*
 
State*
 
Pincode*
 
Clinic Address with State Name and Pincode
Photo*(only .jpg, .png, .jpeg formats allowed)
 

Payment Details

Payment Mode *
 
Sl NoMembership TypeAmountDescription
1 LIFE MEMBER 9558.00 Life Membership: Rs. 8,000/- + admission fee of Rs.100/- + Rs. 1,458/- 18% GST
2 ASSOCIATE LIFE MEMBER 9558.00 Associate Life Membership: Rs. 8,000/- + admission fee of Rs. 100/- + Rs. 1,458/- 18% GST
3 PATRONS 29500.00 Rs.25,000/- as one time payment + Rs. 4,500/- 18% GST
Amount*
 
Date*
 
Transaction Number*
 
A/C Holder Name*
 
Bank*
 
Branch*
 
Upload Scanned Copy * (File Size Max 500KB)
   
Bank Account Details

Bank Name : Bank of Baroda
Branch : Deralakatte Yenepoya University Branch
A/C Number : 74460100002110
A/C Name : Indian Academy of Oral Medicine and Radiology
Account Type : SB
IFSC : BARB0VJDEYU (0 read this as ZERO)
MICR : 575012025

Certificate

College name of MDS completion :*
 
Guide Name :*
 
HOD Name :*
 
BDS Certificate* (File Size Max 500KB)
 
MDS Certificate* (File Size Max 500KB)