IMA CBE Life Membership Form (Single / Couple)

Requirements

  1. Passport Size Photo 2 Nos.
  2. Degree Certificate Xerox 2 Nos. Self attested
  3. Medical Council Registration certificate Xerox 2 Nos. Self attested
  4. Aadhar Card Xerox 2 Nos Self attested
  5. Fees Single Rs.20,355/- & Rs.12,980/- (Separate cheque)
  6. Couples Rs.31,211/- & Rs.18,880/- (Separate cheque)
  7. Cheque in favour of “Indian Medical Association, Coimbatore”
  8. Cheque for Minimum Rs.1,000/-(for single) Rs.2,000/- (for Couples) in the name of
    “CIMACT” or “Coimbatore IMA Charitable Trust”.
  9. For CME Cr.Hours Rs.750/- (Per person) “Indian Medical Association, Coimbatore”
    (If required by the member)
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