ANMDA Membership Application Form
Australasian Nepalese Medical and Dental Association (ANMDA) invites eligible health professionals to apply for membership by filling out the form below. You will be contacted within a few days after the form is submitted.

The recent series of devastating earthquakes in Nepal has further galvanized us to take strong and immediate action. We request your support and active participation in this charitable cause by becoming a registered ANMDA member. By working together, we can make a bigger and lasting impact.

Prefix *
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Mobile Number *
Your answer
Address *
Your answer
Membership
MEMBERSHIP TYPES

General with voting rights: those who are from Nepal or of Nepalese origin and have AHPRA membership and those who have completed both AMC or ADC examination.

Associate members with voting rights: Those doctors from Nepal or Nepalese origin who are preparing and part completed AMC or ADC exam, those who are in research field and other university courses or working in public and like areas etc

Affiliate Members: members from brother or sister associations including allied health

Honorary Members: Those who are granted membership by ANMDA for their special role or for a special reason

Membership Type *
Professional Details
Are you registered with AHPRA? *
If yes, please provide your AHPRA registration number.
Your answer
What is your speciality? *
Please provide further details on your speciality? *
E.g. GP, Psychiatrist, Orthodontist etc.
Your answer
Membership Fees
General Members:
- Fully qualified in the area of expertise and practicing $200/annum,
- Registrars/ trainees/ medical officers and Interns $100/annum
Associate Members: $50/annum
Affiliate Members: $50/annum
Honorary Members: Free
AMC Candidates: Free

Financial hardship will be considered at the discretion by the Executive Committee.

Please transfer your membership fees via bank transfer to the official ANMDA account.

Account Name: ANMDA
BSB No: 062-174
Account No: 1055 7714.
Description: Please include your name

I hereby apply to be elected a member of the Australasia Nepal Medical and Dental Association, and agree if elected, to observe the principles stated in the Declaration of Geneva and the rules of ANMDA. *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms