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

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.

Optometry Confederation of India

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