Apply for membership Current Start Page 2 Page 3 Complete Approval of membership principles and privacy policy By ticking this box, your organisation agrees to comply with UICC's Membership Principles and agrees to UICC's Privacy policy. Please also note that by joining UICC membership, you agree that your organisation (and key staff members) will be at times introduced to other member organisations, to facilitate networking and collaboration. Section 1 - Organisation details Type of membership requested Full Associate Organisation Name Organisation Type Cancer Society Governmental Agency Hospital / Treatment Centre / Research Institute Patient Support Group Professional Association Other Organisation Type specification (if you answer other please specify) Is cancer control the main activity of your organisation? Yes No Please provide a short summary on how your organisation is involved in cancer control Please note that this description will be used on the uicc.org website with your organisation's profile. Does your organisation focus on a specific cancer? No Yes If you answered ‘yes’, please specify (Focus on specific cancer) Breast cancer Cervical cancer Lung cancer Liver cancer Prostate cancer Colorectal cancer Stomach cancer Other (please state / explain) If you answered ‘other' please specify (Focus on specific cancer) In which year was your organisation founded? How did you hear about UICC ? How many people does your organisation employ as staff? - Select -1 - 1011 - 5051 - 100101 - 500501 - 10001000+ How many people work at your organisation as volunteers? - Select -1 - 1011 - 5051 - 100101 - 500501 - 10001000+ Organisation's annual revenue in USD - Select -0 - 10'00010'001 - 50'00050'001 - 100'000100'001 - 200'000200'001 - 1'000'0001'000'001 - 5'000'0005'000'001 - 10'000'00110'000'001 - 100'000'000100'000'001 - 200'000'000200'000'001 - 300'000'000300'000'001 - 400'000'000400'000'001 - 500'000'000500'000'000+ What is the governing body of your organisation? In which of the three UICC areas of work are you interested? (Priority interest) Convening (World Cancer Congress, World Cancer Leaders' Summit, World Cancer Day campaign, Virtual Dialogues) Capacity Building (Fellowships, workshops, leadership, online learning, seed-funding / project grants, support and resources etc.) Knowledge, Advocacy and Policy (UICC works across the policy cycle to help bring together the evidence base for effective cancer control, develop tools to support national advocacy and share examples of successful policy change) What other international bodies is your organisation a member of? What are your expectations of UICC membership? NB: If at any point you wish to go back and forth between pages, you will need to fill in all the mandatory fields on the page you are on, before you can view the previous page. Your data will be saved even if you go back and forth. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
