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Infectious Diseases Society of Pakistan - 1999 Membership Application Form
Please fill and print form. Allow up to 4 weeks for application processing.  Journal subscriptions begin within 2 months of receipt of application.

Name:

Date:

Degree (check all that apply):  MB.BS  MD  MRCP   FRCS  FCPS  MSc  Ph.D.   Pharm. D.   MRCP Path  
Dip Am. Board of  
Other

Specialty/Field of Interest

 

Mailing Address Information

Institution/Organization: 

Department: Division: 

Mailing Address: (No post office box,  please):

City: Zip Code: Country:

Email: 

Business Phone #:Fax #:

Mailing address provided is my business address  Mailing address provided is my home address

 
Subscription Information:
Membership to the Infectious Diseases Society of Pakistan is gratis.  However, subscription to its publication, Infectious Diseases Journal of Pakistan, is mandatory.  Subscription rate within Pakistan is Rs.300/- for a period of one year (4 issues).

CASH (Rs. 300/-)
I ENCLOSE A CROSSED CHEQUE/BANK DRAFT FOR
RS. 300/- PAYABLE TO CREATIVE ENDEAVORS
(Personal cheques only accepted from Karachi)
Cheque No. ______________________________

 

 For Infectious Diseases Society of Pakistan Office Use only:
Approval Code: ____________________

Initials: ___________________________

Member # Assigned: _________________
Application Submission Information: Comments: ________________________
__________________________________
__________________________________
__________________________________
Mail to:
Creative Endeavors
(Re:  Infectious Diseases Society of Pakistan)
25 Amir Khusro Rd, Blk 7&8, CP Berar Housing Society
Karachi 75350, Pakistan