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Membership Application

Applying for Membership : Step by step instructions.

Complete and submit Membership Application Online and pay by Pay Pal

Pay by Check

After submitting your application online, print the completed Membership Application and mail this printed version of the completed application along with a check payable to IMASC for Membership dues to:

IMASC

Indian Medical Association of Southern California 2372 Morse Avenue # 604 Irvine California 92614 (949) 316 1157 (949) 316 1158

Please note that IMASC is a nonprofit organization and the membership dues are fully tax deductible.
Our Non-Profit Tax Exempt ID is 330044199.

Login Detail

eg.sam_001,alex2001 etc.

Mailing Address - Home

e.g. 408-123-2345
e.g. 408-123-2345

Office Address

e.g. 408-123-2345
e.g. 408-123-2345

Medical School Attended

Residency Training

Fellowship Training

Ever surrendered a medical license under the threat of a disciplinary action by any Medical Board:

To qualify for a free membership to MSRF section, please send us copy of ID issued by the Medical School or the training hospital.

You can either upload a copy of your ID
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