This form is to be used by those who wants to apply offline. Please download, take a print-out and fill up the form carefully with correct information in block letters.

The filled-up membership form must be sent along with the Cheque or DD or Online Payment transaction receipt to the Secretariat address provided below:

Kosish the hospice

Address:- Pindrajhora, Village – Obra, Thana – Pindrajora, District – Bokaro, PIN – 827013.

 

Cheques / DDs must be crossed and in favour of “Indian Association of Palliative Care”, and payable at Bokaro Steel City, Bokaro, India. (Current Account No. 33808019294; IFSC Code SBIN0000246; State Bank of India; Bokaro Steel City, Sector – 4).

 

Those who wants to apply online, please visit this LINK to fill up the online form and submit.