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.

Basic Details

Name*
 
Gender*
 
Membership Type*
 
Contact Number*
 
Date of Birth*
 
Photo*
 
Email ID*
Password*
 
Confirm Password*
   
Address*
 
State*
 
Pincode*
 
Clinic Address

Payment Details

Payment Mode *
 
View Registration amount
Sl NoMembership TypeAmountDescription
1 LIFE MEMBER 8600.00 Life Membership: Rs. 8,000/- + Rs. 500/- for ID Card + admission fee of Rs.100/-
2 ASSOCIATE LIFE MEMBER 8600.00 Associate Life Membership: Rs. 8,000/- + Rs. 500/- for ID Card + admission fee of Rs. 100/-
3 PATRONS 25000.00 Rs.25, 000/- as one time payment
Amount*
 
Date*
 
Transaction Number*
 
A/C Holder Name*
 
Bank*
 
Branch*
 
Upload Scanned Copy * (File Size Max 500KB)
   
Bank Account Details

Bank Name : Vijaya Bank
Branch : Raja Rajeswari Nagar, Bengaluru
A/C Number : 401101011006397
A/C Name : Indian Academy of Oral Medicine and Radiology
Account Type : SB
IFSC code : VIJB0001422

Certificate

BDS Certificate* (File Size Max 500KB)
 
MDS Certificate* (File Size Max 500KB)
 
Register