Doctor's Registration Form
Indian Cancer Society (ICS), a Public Charitable Trust founded in 1951 is India’s oldest National Anti-Cancer Organization dedicated to the fight against cancer through its numerous country wide activities. ICS strongly believes in the well-established premise that “Cancer is curable if detected early”. ICS is in the forefront with its Cancer Prevention and Awareness programs and its clinic and Mobile Cancer Detection camps. In our fight against Cancer we need to collaborate with general doctors and also specialists in various capacities. If you wish to put your skills to use for this noble cause then kindly fill in the required details in the form below and our team will get back to you.
The fields marked * are mandatory.
Name *
Your answer
Age *
Your answer
Gender *
Contact Number *
Your answer
Email Id *
Your answer
Qualification *
Speciality
Your answer
Any Hospitals or Organizations you are associated with *
Your answer
Availability *
Required
Any Specific Timings? *
Your answer
Your Preferred Location to Work (Anywhere in India) *
Your answer
In which capacity would you like to work with ICS - You may select multiple options *
Required
Your Comments/Any other information you would like to give us *
Your answer
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