Membership Registration | Australian Indian Medical Association of WA(INC)

AIMA WA Membership is based on Calendar Year from 1st January to 31st December

Choose Membership:

First Name

Last Name

Phone Number

Email

Speciality

Address

Password

Confirm Password

Declaration

I/ We solemnly affirm that:
to abide by the values of Australian Indian Medical association WA at all times and by rules that the Management Committee may establish periodically.
to advise the Secretary in any change in my/our contact details
agree to the privacy policy, terms & conditions of the AIMA WA Website
to any verification of the information provided on this form and understand that the membership will be effective from the date this application is approved by the Management Committee.
I/We understand that the latest copy of the Constitution is available on request

Payment Details

Credit /Debit Card Number

CVV

Expiry Month

Expiry Year

COMMONWEALTH BANK
VISA, AMEX, MASTERCARD
SSL SECURE PAYMENTS

Can’t read the image? click here to refresh

AIMAWA News Letter

News Letter is Released Quarterly for All Its Members