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*Required Information
First Name *
 
 
Middle Name 
 
 
Last Name *
 
 
Email Address *
 
 
Username *
 
 
Password *
 
 
Confirm Password *
 
 
Graduation Year *
 
 
Membership Type *
 

(Need to send a letter from the program regarding trainee status. Need to be send to rnayyar116@gmail.com)

 
Primary Speciality 
 
 
Secondary Speciality 
 
 
Academic/Research Appointment
 
 
Gender *
 
Male  Female 
 
Upload Photo
 

(Only .jpg,.gif,.png files are allowed and also file size sould be less than 1 MB )
 
Upload Copy of the degree
 

(Note: All new members should upload their degree with the membership form, or they can take a picture of degree and upload it or take a picture and email it to Dr Rahsid Nayyar at rnayyar@gmail.com)


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Website