Apply for Membership

Step 1 of 6

Membership

Choose the category you are eligible for. The fee updates automatically.

Type of IAPMR WB Branch membership *

PGT member Rs. 1,000/- Post Graduate Trainee IAPMR PGT membership, and Doing PG (PM&R) in any West Bengal institution, or permanent residence in West Bengal Life member Rs. 3,000/- Lifetime membership IAPMR life membership, and Permanent residence in West Bengal, or PG degree in PMR from a West Bengal institution Associate member Rs. 2,000/- Contact the membership committee / EC before applying Any IAPMR member of any state, or Any doctor of another specialty or MBBS with permanent residence in West Bengal

Associate membership needs prior clearance from the membership committee or EC. Contact the branch before applying.

Step 2 of 6

Personal details

Enter your details exactly as they appear on your council registration.

Full name * Recorded in upper case.

Email * Your receipt and application copy go to this address.

Mobile number *

Gender *

MaleFemaleOther

Date of birth *

IAPMR membership number * The national IAPMR number, available under Login › My account at iapmr.in.

Registration number and medical council * Medical Council of India or your State Medical Council.

Permanent address *

Correspondence address *

Same as permanent addressDifferent address

Step 3 of 6

Qualifications

Undergraduate and post-graduate qualification details.

MBBS year of passing *

MBBS institution or university *

PG degree *

MDDNBOther

PG discipline * PGT applicants: the discipline you are currently pursuing.

PG year of passing * PGT applicants: expected year of completion.

PG institution or university *

Step 4 of 6

Work

Your present posting and areas of interest.

Current position, posting, designation or attachment *

Experience

Areas of interest or specialisation

Step 5 of 6