Member Registration – Asia Pacific Ophthalmic Trauma society

Name*
First Name (Required) Middle Name (Required) Last Name (Required)
Date of Birth*
DD slash MM slash YYYY
Gender*
- Male
- Female
Nationality*
Basic Qualifications, Year and University*
Post graduate (Residency) Ophthalmology Qualification / Institution*
Fellowship (Speciality)*
Institute*
Year*
Current Affiliation(s) and Position*
Institute / Clinic / Hospital Address*
Academic Interest*
Contact Phone*
Fax
Email*
Website
Work Experience*
Place*
Year*
Other Professional Memberships*
Organization & Membership Number*
Trauma relevant Publications / Presentations. List all the Publications / Presentations related to Trauma*
Upload your Photo
Accepted file types: jpg, png, Max. file size: 1 MB.
Accepted file types: jpg, png. File size should not exceed 1 MB
Membership Type*
- Lifetime Regular membership
- Allied Health Membership
Hidden
Upload the letter of training from the Institute
Accepted file types: jpg, png, pdf, Max. file size: 5 MB.
Amount Payable
$0.00
- Subscribe to APOTS newsletter
Payment Method*
- Paypal or Credit Card
- Bank Transfer

Please be advised that our online membership application form has been temporarily taken offline for planned upgrades.
We will resume accepting APOTS membership applications on 14th September.

Thank you for your cooperation and understanding during this maintenance period.

Explore the Horizon of Ophthalmic Trauma with APOTS