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Membership Application

Active Members

Dues$30 per calendar year. $40 Renewals received after January 31.

One who is a CTR, employed as a cancer registrar, or in the field of cancer data management, directly supervises a registry, or who acts as a registry/cancer program consultant. Active members in good standing are entitled to vote, chair a committee and hold elective office.

Associate Members

Dues$25 per calendar year. $35 Renewals received after January 31.

One who is a CTR, employed as a cancer registrar, or in the field of cancer data management, directly supervises a registry, or who acts as a registry/cancer program consultant and supports the purposes of PACR.  Associate members may not vote, hold office or chair a committee, but may serve on a committee

Student Members

Dues: $20 per calendar year. $30 Renewals received after January 31

Must be currently enrolled in college level curriculum and interested in purposes of PACR, but do not meet active requirements.  Student members may not vote, hold office or chair a committee, but may serve on a committee by special appointment. Note: When applying for a student membership, please attach the following information: name of the school and major, expected graduation date (month and year), proof of enrollment (official listing of classes or letter of acceptance) and indicate the number of credits being carried during the current semester.

Sustaining Members 

Dues: $100 per calendar year

Person, institution or organization interested in promoting principles and purposes of PACR.  Sustaining members may not vote, hold office, chair or serve on a committee.    This membership entitles the holder to single membership benefits.


Submission Type:

Renewal New Information Change

Membership Type:

Active Associate Student Sustaining

First Name:
Last Name:
Credentials:
Title:
Home Street Address:
Home Street Address (cont'd):
City:

State:

Zip Code:

Home Phone:
Hospital / Organization:
Business Street Address:
Business Street Address (cont'd):
City:

 

State:

Zip Code:

Business Phone:
Preferred Address:

Home Business

E-mail:

Would you like to be published in the PACR Membership Directory?  

 Yes  No

If you are interested in becoming more involved with PACR, select your interest areas below.  Select one or more.

President-Elect
Vice President
Secretary
Treasurer
Bylaws Committee
Education Committee
Legislative Committee
Membership Committee
Nominating Committee
Program Committee
Public Relations Committee

Comments

If you would like a copy of your completed membership application, please print before you select "submit" below.