43, Amrut Keshave Naik Marg, Fort, Mumbai – 400001. Tel.:022 2201 2358, Fax.: 022 2207 0048

Membership Application Form

(*) Indicates Mandatory Fields
Name of the College / Institute with postal address *
College / Institute established in *
Institute affiliated by the University *
Name of Head of College / Institute with designation *
Qualification of Head of Institute (General and Technical) *
Official contact
E-mail address * Fax *
Phone No. with STD code * Cell Phone *
Name and Duration of Optometry courses conducted by the Institute
a) b)
Academic year starts in the month of *
Covered area of the Optometric college / Institute *
Details about Class room and Laboratories with equipments available
in the College / Institute *
Description of the construction which occupied by the Optometry
College / Institute *
Number of students admitted in the every first year of the course *
Number of seats allotted in the first year by the University *
Number of students passing out every year from each course *
Number of students having passed out till date *
Details about eligibility criteria and admission procedure in the first year
of Optometry course *
Number of fulltime faculties in the College / Institute *
Number of fulltime Optometry faculties in the College / Institute *
Number of part-time faculties in the College / Institute *
Number of part-time Optometry faculties in the College / Institute *
Qualification of all faculties in the College / Institute *
Detail syllabus of each optometry course *
Semester examination procedure of each optometry course *
Number of workshops and seminars conducted by the College / Institute every year *
Details about Optometry Clinic / O. P. D. facilities in the College / Institute
with equipments and instruments list *
Your suggested Date for Inspection after one month before three months
from the date of submission of this form *
Our Membership fees structure is as under
  1. One time subscription charges Rs.10,000/-
  2. Yearly renewal charges Rs.10,000/- (financial year April – March)
Kindly issue Demand Draft in the name of “Association of Schools & Colleges of Optometry” and send the same along with form & other college details, to Mr. Vivek Mendonsa, President, Association of Schools & Colleges of Optometry, 43, Amrut Keshav Naik Marg, Fort, Mumbai – 400 001.
Details Of Demand Draft
D. D. No. * Rs.*
Date of Issue * Name and Branch of Bank *