INASCRS Membership Application

The INASCRS offers cataract and refractive surgeons a forum for communicating with colleagues. INASCRS membership is offered to qualified ophthalmologists in the Indonesian Country and must be approved by the board Officers.

Benefits of Double Membership (INASCRS and APACRS) :

• Full membership in INASCRS (3 Years)
• Associate membership in APACRS (3 Years)
• Reduced registration fees at INASCRS & APACRS Congresses/Meeting
• Access to Members Only Area on the INASCRS Website
• Access to Members Only Area on the APACRS Website
• Free subscription to APACRS EyeWorld Asia-Pacific News Magazine
• Membership application subject to approval by Board of Officers
• Membership Certificate upon approval by the Board of Officers

Registration Form

Membership Package

Full Membership

IDR 1.500.000 / USD 112,78
For 3 years (include APACRS membership fee)

Personal Information

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First Name *

Middle Name

Last/Family Name

Title* ProfDr

Birth Date

Institution

Address*

Country*

State

City

Zip Code

Phone Number *

Fax Number

Email *

Academic & Experience

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Medical School

Residency

Year Completed

Ophthalmic Training

Highest Qualification

Year Completed

No. of Years in Ophthalmic Practice

Subspecialty Interest

Have you performed intraocular implant surgery?
Yes No

Estimate no. of operations

Have you performed refractive surgery?
Yes No

Estimate no. of operations

NRA Perdami & Password

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NRA Perdami*

Password * min. 8 characters

Confirm Password *

Payment Method

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Credit Card

ATM Transfer

Please Note : All payment with credit card will be added with 3% administration charge. Other payment option will be charged IDR 5.000/transaction

Submit