Family Benefit Scheme · 2025–26

FBS registration

Fresh enrolment into Dental Surgeons Benefit Trust — Family Benefit Scheme. The same particulars as the IDA Andhra Pradesh registration form. A non-member can submit this form. The secretariat approves it, you pay the age-based joining fee, and only then is your FBS ID issued.

01
Submit this form
02
Admin approves
03
Pay the joining fee
04
FBS ID is issued

DSBT – FBS membership form

Personal informationSurname *Name *Gender *Date of birth *Your ageRegistration feeContributory depositTotal amountIDA / specialty dental association membership *Number *Do you have any health problems? *Mobile *Email *Mother / Father / Spouse *Name *

AttachmentsUpload passport size photograph *Upload Aadhaar with signature *Upload State Dental Council registration certificate *Upload association membership card *Date of birth proof *Upload date of birth proof *

FBS correspondence addressAddress *City *District *State *Pincode *Phone

Permanent addressSame as FBS correspondence addressAddress *City *District *State *Pincode *Phone

Nominee 1Full name *RelationMobileEmailPercentage of benefitUpload Aadhaar with signature / thumb impression *

Nominee 2Full nameRelationMobileEmailPercentage of benefitUpload Aadhaar with signature / thumb impression

Nominee 3Full nameRelationMobileEmailPercentage of benefitUpload Aadhaar with signature / thumb impression

ReferenceReference / information of DSBT FBS provided by

I do hereby declare that the above information is true and I have not withheld any information whatsoever regarding my particulars and my membership can be terminated if any information is found to be incorrect. I agree to pay the Fraternity Contributions as per the rules and regulations of this Scheme.I further agree to abide by all the rules and bye-laws of DSBT — Family Benefit Scheme and also any amendments to be made from time to time. I will not proceed legally against DSBT — Family Benefit Scheme without going to the Arbitration Committee of the FBS. Any change of my address will be informed to the FBS office from time to time.

The secretariat reviews this form before payment. Your FBS ID is issued only after the joining fee is received. JPG, PNG, WEBP, or PDF, up to 4 MB each.

For any clarification write to familybenefitscheme@gmail.com. Already a member? Sign in.