IRA

MEMBER REGISTRATION

Create your IRA account. It will take less than 5 minutes. If you have already have an account kindly Login.

Title *

First Name *

Middle Name

Last Name *

Date of Birth *

Gender *

Code *

Mobile Phone *

Code

Alternate Phone

Email Address *

Profile Photo (Max 2 MB size)*

Address for Communication

Address *

City *

District *

State *

Pincode *

Country of Residence *

Permanent Address

As Above

Address *

City *

District *

State *

Pincode *

Country of Residence *

Consent from the proposer regarding suitability of the candidate for IRA membership

IRA Membership No. *

Title

First Name

Last Name

IRA Member Since(Year)

Proposer email

Kindly enter the correct Proposer Membership Number (e.g. LMXX/AMXX/OMXX/OSMXX).

Professional Qualifications

Note: Please attach scanned copies.

Qualification *	Year *	University *	Attachment (Max 2 MB size) *

Qualification	Year	University	Attachment (Max 2 MB size)

Appointments held

Designation	College/Hospital	Duration	Job Description	Action

Rheumatology Experience

Note: Proof of two years rheumatology experience must be attached.

Designation	College/Hospital	Job Description	Duration	Attachment (Max 2 MB size)	Action

Publications/Awards in Rheumatology & Clinical Immunology

Upload Rheumatology CME/Conference Certificates

Note: Not Applicable For DM/DNB Rheumatology/trainee/qualified.

Attachment (Max 2 MB size)
Attachment 1:	Attachment 2:

Are you applying for ?

Life Membership (LM)

Overseas Membership (OSM)

How would you like to receive the Indian Journal of Rheumatology?

Online

Hardcopy

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For any assistance/query related to registration please email us at admin@indianrheumatology.org