Online Membership Form


Please register for Membership by filling the form below :-
*Mandatory fields    
Personal Details *
Family Name :
First Name :
Nationality :
Contact Number :
Email address :
Postal address :
Zip code :
City :
Country :
Professional Qualification *
Position :
Hospital/Practise/Institute :
Specialty / Subspecialty :
Area of Interest :
Educational Details
M.D. / Ph.D. / where, when :
University Degree :
Training Received :
     
 

Note: Your membership will be confirmed only upon successful payment of membership fee. Applicants without relevant professional qualification would be reviewed, and membership is subject to approval by AFSM.

In case the online application form is under system maintenance, please download the application form in word format (click here) and return to administrative office afsm.membership@gmail.com

Please contact the administrative office (afsm.membership@gmail.com) should you have any question.