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Membership
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Membership Registration
Personal Details
State
Andaman and Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra and Nagar Haveli
Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Pondicherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Telangana
Tripura
Uttar Pradesh
Uttarakhand
West Bengal
City
Applicant Name
Date of Birth
Marital Status
Single
Married
Blood Group
Phone No.
E-mail
Address
Educational Information
H.S (12th) Admission Year
H.S (12th) Passing Year
Board / University
B.OPTOM Admission Year
B.OPTOM Passing Year
Board / University
M.OPTOM Admission Year
M.OPTOM Passing Year
Board / University
Applicant Type
Student
Professional
Membership Period
Periodical
Lifetime
Periodical Membership
Fees-1000/-
(For 3 years) and Lifetime Membership
Fees-5000/-
Documents Information
(*All Documents Must Be Attach Before Submit*)
Profile Image
JPG Image (Max 100 KB)
Identity Document
JPG Image (Max 200 KB)
H.S.Marksheet
JPG Image (Max 200 KB)
Student Optometry Registration / Last Semester Marksheet
JPG Image (Max 200 KB)
Professional Optometry Certificate / Final Semester Marksheet
JPG Image (Max 200 KB)
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