Cancer symptom trials organisational membership application

* indicates mandatory fields

Title

Please provide the organisation e-mail address for membership correspondence.

Please provide the name of a current CST member to nominate you. If you are not currently in contact with CST members, please e-mail us for advice to CST@uts.edu.au

Please provide the name of a current CST member to second the nomination.

Occupations/disciplines*

Please indicate the occupations and disciplines represented at your organisation. Tick all that apply.

Please provide specialisation details for your organisation, if applicable.

Cancer symptoms*

Which cancer symptom/s are you interested in? You may tick more than one symptom.

Cancer types*

Which types or cancer are you interested in? You may tick more than one type.

Current clinical trial recruitment*

Does your organisation recruit to clinical trials?

Future clinical trial recruitment*

Would your organisation like to be an active clinical trial recruitment site in the future?

Funding*

Has your organisation, or its staff members been awarded competitive funding (current or past)?

COSA membership*

Is your organisation a member of the Clinical Oncology Society of Australia (COSA)?

Clinical trial group membership*

Is your organisation a member of any other Cancer Cooperative Trials Group, or other clinical trial group?

Country*

Where is your organisation located?

Location*

Where is your organisation located?

Declaration*

I agree that the information provided is true and correct. I agree to the provided organisational information being saved in a confidential database to be used by Cancer Symptom Trials to: contact us about research opportunities within Cancer Symptom Trials; send newsletters to the provided e-mail address; send event invitations to the provided e-mail address.


 
Acknowledgement of Country

UTS acknowledges the Gadigal people of the Eora Nation, the Boorooberongal people of the Dharug Nation, the Bidiagal people and the Gamaygal people, upon whose ancestral lands our university stands. We would also like to pay respect to the Elders both past and present, acknowledging them as the traditional custodians of knowledge for these lands.