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JOIN   IAGES

President

Dr. Sayandev Dasgupta

098300 30390

sayan1in@yahoo.co.uk

Hon. Secretary

Dr. Sunil D. Popat

098250 09199

drsdpopat1@gmail.com

Hon. Treasurer

Dr. Ramen Goel

098201 70763

ramengoel@gmail.com

APPLICATION FOR IAGES MEMBERSHIP

Please Pay Rs.8260 ( Registration Fees Rs.7000 + 18% GST ) as Membership fees**. After submitting this form, you will be directed with Billdesk payment gateway and on successful completion, your registration will be automatically accepted.
Incase of Payment failure, Click here and perform Repay
Membership Number will be given to members after successful completion of payment and it will be given in 2 weeks from Honorary's office.



To,

The Hony Secretary IAGES

Dear Sir,

I wish to apply for active / student / associate / international / corporate membership of the IAGES.

Personal Particulars (In Block Letters)

Marked fields are Mandatory*

Name AS in degree certificate*
















Academic Qualification*

Academic QualificationYearUniversity/InstitutionCountry StateMedical Registration No


Training In Endoscopic Surgery/Procedures*

InstitutionFrom(Date)DurationTeacher


Appointments/Experience*

DesignationFromInstitutionTo


Sponsors*

NameIAGES Membership No.


Membership Of Other Associations/Societies*

Association/SocietyMembership No.
I, hereby certify that the above information is correct to the best of my knowledge and I agree to Abide by rules and bye-laws Of the Indian Association of Gastrointestinal Endo-Surgeons,





* Scanned Copies of only Original Documents will be accepted.

* Kindly upload jpeg/jpg/png/pdf/doc format

* : * : * : * : (Aadhar Card / Passport allowed)
* : * : * : * Only front facing photo acceptable.*Kindly upload jpeg/jpg/png/pdf/doc format