1 Start 2 Page 2 3 Page 3 4 Complete UICC offers the following types of membership Full Available to organisations, networks or entities that are substantially engaged in evidence-based cancer control or research and have appropriate organisational structures. Full members may submit nominations for the Board of Directors and may submit activity proposals to the Board.Annual dues: CHF 3,000 Associate Available to organisations, networks or entities that support UICC objectives.Annual dues: CHF 1,500 Please note that processing your application will only take one week. Incomplete applications will not be reviewed. Membership will become effective upon UICC approval of the application and receipt of the first annual membership dues. Section 1 - Organisation detailsOrganization What type of membership do you wish to apply for? * Full Associate Name of Organisation * What is your organisation type? * Cancer Society Governmental Agency Hospital / Treatment Centre / Research Institute Patient support group Professional Association Other Please choose that which best describes your facility. If you answered 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 * Describe the main activity / focus of the organisation Does your organisation focus on a specific cancer? Yes No If you answered yes, please specify Breast cancer Cervical cancer Lung cancer Liver cancer Prostate cancer Colorectal cancer Stomach cancer Other (please state / explain) If you answered Other please specify In which year was your organisation founded? Where did you hear about UICC? * How many people does your organisation employ as staff * This field needs to be answered with numbers and not letters. How many people work at your organisation as volunteers * This field needs to be answered with numbers and not letters. Organisation's annual revenue in USD * This field needs to be answered with numbers and not letters. Not spaces and/or punctuation allowed. What is the governing body of your organisation? * In which of the 3 UICC priorities are you interested ? Advocacy Events & Campaigns International Programmes 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. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. What code is in the image? * Enter the characters shown in the image.