Optometry Confederation of India

Personal Details

First Name*

Middle Name

Last Name*

Date of Birth*

Email Address*

Mobile Number (max 10 digit)*

Alternate Number

Password*

Confirm Password*

Father's Name

Gender*

Male

Female

Residential Address

Country

State

City

PIN Code

Address 1

Address 2

Courier/ Postal address for the registration certificate

Country*

State*

City*

PIN Code*

Address 1*

Address 2

Aadhaar Number

Qualification Details

Optometry Qualification Diploma

Optometry Qualification Degree

Optometry Qualification Others

Name of College

Other Institution

Name of University

Other University

Year of Passing Diploma / Degree

Duration(Total Years)

Are you a member of any other Optometry Association?

N/A

Yes

Association Name

Have you completed Master's in Optometry?

N/A

Yes

Pursuing

Membership Number

Year of Passing Master’s

Master's University Name

College / Study Center Name

Have you completed PhD in Optometry?

N/A

Yes

Year of Passing PhD

Are you currently working independently?

N/A

Yes

Upload Documents

Photo (Passport Size) (Only JPG and JPEG file of min 100 kb & max 2 MB size is supported)*

12th Certificate (Pre-University) (Only JPG and JPEG file of min 100 kb & max 2 MB size is supported)*

3rd year Marks Certificate (for students) mentioning the college / study centre name*

Optometry Degree (Only JPG and JPEG file of min 100 kb & max 2 MB size is supported)*

Master's Degree Certificate(Only JPG and JPEG file of min 100 kb & max 2 MB size is supported)

PhD Degree (Only JPG and JPEG file of min 100 kb & max 2 MB size is supported)

Current Professional Details

What is your current professional status?*

Hospital

Opticals

Private Practice

Corporate

Academics

Public Health

Not working

Others

Current Designation

Name of the Organization

Address of Organization

Country

State

City

PIN Code

Address 1

Address 2

Practice Locator Details

Other details

How did you know about us?

Mailer

Website

Friend

Conference

OCI Member

Institute

Association

Others

Declarations

I confirm that "OCI" can send Optometry information and other related information to your email id mentioned in this form.

All the information mentioned above are true to my conscience.

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Optometry Confederation of India

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