Life Membership Form

I wish to become a member of the Society of Pharmacovigilance, India. I have read the constitution
of the academy and agree to abide by it.

Are you actively engaged in work concerning Pharmacovigilance?

Type of membership desired (Please tick the following option):

Note: The admission fee of Rupees Fifty shall be chargeable at the initial admittance to the Society. The subscription for ordinary membership is valid for calendar year and shall become due on the 1st January each year.

Note: All the payments be made either in cash/demand draft in favour of “Society of Pharmacovigilance, India”, payable at Aryavart Bank (Civil Lines, Agra) and should be sent/mailed to the Treasurer. Please add Rs. 45/- for outstation checques. Online payment can be made to the A/C No: 110410110001061
A copy of the payment may be sent to the email ID of the Secretary, SoPI