SOHNSS :: Membership

MEMBERSHIP FORM

1. TYPE OF MEMBERSHIP

* Indicates required field

Categories *

Full Membership (SGD 30.00) Associate Membership (Complimentary)

Full membership: For O-HNS Specialists who are registered with the Singapore Medical Council
Associate Membership: For registered Medical Practitioners and to persons who are not medically qualified, but whose occupation or interest is concerned with the art and science of Otolaryngology

2. PERSONAL PARTICULARS

Titles *

First/Given Name *

Last/Family Name *

Date of Birth *

MCR No *

Marital Status *

Gender *

Religion *

Nationality / Citizenship *

Residential Address *

Line 1

Line 2

City

State

Zip Code

Country

Personal Email *

Contact Number *

3. PLACE OF WORK

Institution / Organisation *

Designation / Job Title *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Department (if any) *

Work Email *

Work Phone *

4. EDUCATION QUALIFICATIONS (in chronological order)

a. Qualification Attained *

Year Attended / Completed *

Institution & Country *

Course / Major (s) *

b. Qualification Attained *

Year Attended / Completed *

Institution & Country *

Course / Major (s) *

c. Qualification Attained *

Year Attended / Completed *

Institution & Country *

Course / Major (s) *

Submit

MEMBERSHIP FORM​

1. TYPE OF MEMBERSHIP

2. PERSONAL PARTICULARS

3. PLACE OF WORK

4. EDUCATION QUALIFICATIONS (in chronological order)

MEMBERSHIP FORM