DCCC

Join Us
Membership Application Form

Welcome to the DC Cancer Consortium! We hope you will consider joining us in the fight to reduce cancer incidence and mortality in the District of Columbia. We number more than 50 organizations and individuals in our membership. Please follow the instructions below -- and we look forward to working with you in the future.

DC Cancer Consortium Membership Requirements

1. DC Cancer Consortium membership is open to any organization OR individual that meets the following requirements:

a. Be a legally operating entity within the District of Columbia (e.g., non-profit organization, for-profit corporation, governmental agency) OR be an individual (e.g. advocate, cancer survivor, concerned citizen) that is interested in working towards reducing the burden of cancer in Washington, DC.

b. Endorse the mission, vision, roles, and values of the DC Cancer Consortium.

c. Agree to be identified as a DC Cancer Consortium member organization or individual.

2. Official representatives of member organizations of DC Cancer Consortium (DCCC) have the following rights and responsibilities:

a. Attend DCCC meetings regularly.

b. Actively participate on a DCCC committee.

c. Communicate their organization’s viewpoints to the DCCC and inform their organization of the DCCC decisions and activities.

d. Support implementation of the DC Cancer Plan by taking specific action within the member’s own organization or in collaboration with other members or member organizations to help achieve one or more of the DC Cancer Plan’s priorities on a regular basis.

e. Agree to support and participate in efforts to evaluate implementation activities and to assess effectiveness in achieving plan objectives and goals.

f. Retain the right to resign their membership at any time.

3. Individual members of DC Cancer Consortium (DCCC) have the following rights and responsibilities:

a. Attend DCCC meetings regularly.

b. Actively participate on a DCCC committee.

c. Represent their individual views to the DCCC.

d. Support efforts to implement and evaluate the DC Cancer Plan.

e. Retain the right to resign their membership at any time.

DC Cancer Consortium Membership Instructions

1. Fill out one application per organization. If you are not affiliated (or choosing not to be affiliated) with an organization please fill out an application as an individual member.

2. Organizational members complete Sections A, B, C and E.

3. Individual members complete Sections D and E.

4. Return application by postal mail with original signature. Mailing instructions are covered in Section E.

Download/Print the Membership Application Form

You must have a PDF reader program installed. To download a free Adobe PDF Reader click here

 

 

DC Cancer Consortium - 4125 Albemarle St. NW - Washington DC 20016
Phone: 202-895-9447
Email: info@dccancerconsortium.org