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Membership application form (Online / Hard copy)and

electronic payment options

Membership Application From PDF

Download. Fill-up. Attach Passport Photo, Draft / Multicity Cheque for Membership subscription. Send through India Post to the Office Secretariat of ACOIN as in the footer of this page.

All Memberships will be Life Membership.

Indian Medical practitioners holding allopathic qualifications under Schedule I and III of Indian Medical Council Act, 1956 and engaged in Community Eye Health Care Service can apply.     Detail in article V of constitution here.

Please fill up and submit this online application form along with payment details

Payment Options:

There are 5 (Five) options for the payment of subscription of membership as mentioned below.

Please decide the method of application for membership and choose the option of payment accordingly.

Net Banking and Core Banking options:

 

1) NEFT bank transfer from any bank by using respective bank's proforma in favour of "ACOIN Life Membership Fund" account as mentioned. The UTR No. After transaction to be mailed to acoinmail@gmail.com and SMS to Dr. Swapan Samanta, Hony. Secretary at the mobile no: +91 9434023759.

 

2) Internet Bank transfer in favour of the "ACOIN Life Membership Fund" account as mentioned. The transaction ID to be mailed to acoinmail@gmail.com and SMS to Dr. Swapan Samanta, Hony. Secretary at the mobile no: +91 9434023759

 

3) Direct cash or cheque may be deposited in any branch of SBI in favour of the "ACOIN Life Membership Fund" account as mentioned and the receipt may be scanned or photographed by smart phone and sent by message to +91 9434023759 or E-mail to acoinmail@gmail.com.

 

The confirmation of membership will be intimated after verification of transaction against the respective UTR No. /  Transaction Id. No. / Scanned receipt.

 

Cheque / Draft / Cash Options

 

4) Multicity cheque or demand draft to be drawn in favour of “ACOIN Life Membership Fund” payable at "Tamluk" and sent to the office of the Hony. Secretary as mentioned in the footer of the page by India Post.

Account Paticulars of

"ACOIN Life Membership Fund"

5) Cash payment at the office of the Hony. Secretary.

Account name: ACOIN Life Membership Fund

Account No. 32202314998

BIC code: SBININBB106

IFS Code ; SBIN0008745

Name of the Bank: State Bank of India

Name of the Branch: Tamluk Railway Station Branch

Address of the Bank: Salgechia, Tamluk, Midnapore (East), West Bengal, Pin – 721636.

Branch Code No.: 8745.

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