Membership Form

Lifetime Membership

Full Membership is available to all practicing Clinical Embryologist in India. Membership is also offered to practitioners in the related disciplines- Infertility specialists, Research fellows/scholars/ Laboratory Andrologist/ Lab technicians/ practitioners within and outside India.

Life Time Membership Category Fee
Indian Nationals Rs. 5,900 incl of GST
Foreign Nationals $ 177 USD incl of GST

Payment Mode:

ONLY NEFT/RTGS MODE OF TRANSACTION IS ACCEPTED (NO OTHER MODE OF TRANSACTION WOULD BE ACCEPTED)
NEFT or RTGS will be accepted for payment.

Bank Details
Bank Name: ICICI Bank
Branch Name: Basaveswar Nagar (Bengaluru)
Branch Address: #29, 1st Main Road, 2nd Block, 3rd Stage, Basaveshwar Nagar, Bengaluru - 560079
Account Name : Academy of Clinical Embryologists
Account No. : 230101000855
IFSC: ICIC0002301

    Personal Info*

    Salutation: Dr.(Mr.)Dr.(Ms.)Mr.Ms.

    Full Name*:

    Gender*: MF

    Postal Address (include City, PIN and Country)*:

    Email*:

    Mobile/Phone (with city code)*:

    Education

    Basic Science*: Basic ScienceB.Sc.M.Sc.PhDOthers

    If others, please specify:

    Medical Science: * MBBSMDDNBFNBMRCOGFRCOGOthers

    If others, please specify:

    Research Interest:

    Attachments

    Your updated one slide CV* (PDF):
    Maximum file size 5MB

    Your recent colour Photo* (JPEG/PNG/GIF):
    Maximum file size 2MB

    Screenshot of the Payment Receipt*:
    Maximum file size 2MB

    Terms & Conditions

    All the information provided here is true to the best of my knowledge.