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Dr. Purvish Parikh
Convener

ICON Trust & ARO
Email: purvish1@gmail.com

Dr. Khurshid Mistry
Manager

ICON Trust & ARO
Email: icon@oncologyindia.org, khurshid.mistry @oncologyindia.org
M: +91 9820739584

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	Become a member today

To become a member you need to:

		Fill a Registration form. You can fill in the registration form online or send in a paper form at the address below.
		Pay membership fees. Your registration will be confirmed only after the membership fees have reached ICON.
		Provide supporting documents. Some documents are compulsory as per the ICON policies.

	Memberships

There are 5 types of memberships.

	1.	Individual Full / Associate (Annual)
	2.	Individual Membership (Lifetime)
	3.	Student Membership (Annual) Members-in-Training are physicians in an academic post-graduate training program.
	4.	Industry/Corporate -Annual Membership Rs.5000/- (Not eligible for Financial assistance and Holding Elected post in ICON)
	5.	Oversees Annual Membership $ 100/-

	Supporting Documents

You need to provide these documents with your application:

		Curriculum vitae.
		To foster and encourage cooperative clinical research in oncology at a national level.
		Statement of your areas of interest.
		Statement of how you could contribute to ICON activities.
		Affirmation of Integrity Statement. This document is required as per ICON policy.
		Members-in-Training need to submit a letter signed by the chief of their department as proof that they are in a post graduate program. This document is required as per ICON policy.
		Conflict of Interest statement This document is required as per ICON policy.

	Payment

All Payments must be by Cheque or Demand Draft in favor of "ICON TRUST". Your registration will be confirmed only after the membership fees have reached ICON.

	Submit To

All completed forms, payments and documents must be submitted to:

Dr Khurshid Mistry (Manager)

ICON Trust & ARO
c/o Indian Cancer Society
74, Jerbai Wadia Road
Bhoiwada, parel,
Mumbai 400012.

Tel fax: +91 22 24176980

Khurshid.mistry@oncologyindia.org
icon@oncologyindia.org

Events