Membership Application

ISNACC Membership Application

Note: Keep your Passport size photo, signature, Educational Qualification (MD/DRNB) Degree certificate, and payment proof ready before starting the application.

PAYMENT METHODS

1. Demand Draft / Cheque : in favour of “Indian Society of Neuro-Anaesthesiology & Critical Care” payable at SBI, Ansari Nagar, New Delhi.

2. Using NEFT / IMPS / Online payment with the below mentioned Bank Account

- Name of Bank: State Bank of India, Ansari Nagar, Delhi

- Name of the Account: Indian Society of Neuro-Anaesthesiology & Critical Care

- Account No: 00000032266570538

- IFSC SBIN0001536

- MICR 110002005

3. UPI details:

- Merchant Name: INDIAN SOCIETY OF NEUROANESTH

- UPI ID : 9650609220@SBI

- QR code is available in the membership details page. Go to Membership Details Page

Membership Category

Personal Details

Prefix

First Name *

Middle Name

Last Name *

Date of Birth *

Qualification *

Designation *

Workplace *

Address for Correspondence

Address Line 1 *

Address Line 2 *

Country *

State *

City *

PIN/Zip code *

Email (Login ID) *

Mobile *

Permanent Address

Address Line 1 *

Address Line 2 *

Country *

State *

City *

PIN/Zip code *

Proposed & Seconded By

Proposed By (Email) *

Seconded By (Email) *

Payment Details

Payment Mode *

Reference Number *

Payment Date *

Amount *

Bank *

Upload Payment Proof *

Uploads

Upload Photo *

Upload Signature *

Educational Qualification (MD/DRNB) Degree Certificate *

Security check

Captcha: What is 9 + 7? *

This helps protect the application form from automated spam. Please allow at least a few seconds to complete the form before submitting.

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Code	Category	Description	Fee (INR)	Fee (USD)
LM	LIFE MEMBER	Neuroanaesthesiologists, Neuro-Intensivists	10000.00	200.00
ALM	ASSOCIATE LIFE MEMBER	Neurosurgeons, Neurologists, Neuropathologists, Intensivists, Neuropathologists, Neuromicrobiologists, Neurobiochemists, Neuroscientists, Neuropsychologists etc	8000.00	200.00
ILM	INTERNATIONAL LIFE MEMBER	Physicians of Foreign origin	Current Coversion Rate	200.00
AM	ALLIED MEMBER	Neuro-Nurses, Neuro-Physiotherapists, and Neuro Technicians	3000.00	75.00

ISNACC Membership Application

Membership Fee Structure