Application Form | OMSSS

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Membership Application Form

First Name

Last Name

Email

Handphone

Professional Qualifications

Clinical and/or research specialty and subspecialty:

Current Employer

MCR #

I am applying for this membership category :

Regular Membership (S$200 p.a.) Please provide a proposer and seconder to support your application

Associate Membership (S$20 p.a.) without IFSO Membership

Associate membership (S$30 p.a) with IFSO Membership

Name of Proposer

Name of Seconder

Email address of Proposer

Email address of seconder

Please make payment via Paynow to (UEN : T11SS0035L) and send a screenshot of your payment receipt to omsss@omsss.sg.

The OMSSS is managed by :

Globewerks International Pte Ltd

22 Sin Ming Lane, #03-85 Midview City

Singapore 573969

Phone +65 65137310

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