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Registration

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*Membership Type :
*Name:
*Gender:
*Present Position:
*College Name:
*Date Of Birth:
*Country:
*State Registered In:
*DCI Reg. No :
*Email Address:
*Mobile Number:
*Blood Group:
Photo:

Communication Address

* Address:
*City/Town:
*State:
*Postal Code:

BDS Qualification

*Degree:
*College:
*Year Of Passing:

MDS Qualification

*Degree:
*College:
*Year Of Passing:

Dissertation /Thesis in brief

*Title:
*Summary:

Documents

Note:
  • Get Ready with scanned copies (color) of your original cerftificates/documents in .jpeg/.jpg/.gif/.pdf format.
  • Each scanned copy size should not be more than 800KB.
  • Dissertation / Thesis document size should not be more than 25MB.
  • All Specified documents are mandatory.
  • All the photocopies of the documents should be self attested by the applicant ( applicable for SLM registration/SLM- LM conversion / direct Life member registration ).
  • Any deviation in mandatory documents and rules will resulting to rejection.

*Select Your Document:
Attach Your Document:
I am ready to pay Registration Fee.

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