I hereby, declare that all information given above is true to best of my knowledge, I have voluntarily applied for the membership of the Academy of Family Physicians of India. I further declare that I am eligible towards membership as per prescribed criteria/ qualification as defined in the Appendix I of the application form. I give this undertaking to abide by the rules and regulation of the society. I shall work and extend my support towards development of family medicine discipline strengthen primary health care in India and shall also be committed towards continuous professional development of myself in order to maintain membership of good standing. I shall maintain professional ethics of high standards. I also understand that all categories of memberships are subject to review every five years with mandatory requirement for maintenance of prescribed skills and knowledge by AFPI time to time. The life membership fee paid by me is valid for fifteen years and governing body in concurrence with general body may levy an updated fee as and when required.

I further declare that this information is true to best of my knowledge and false statement will lead to cancellation of my membership with forfeiting of the membership fee.