The Commission on Cancer (CoC) and the National Accreditation Program for Rectal Cancer (NAPRC) are accepting new committee member applications for new members to join this fall 2024.

New member position request form for CoC
New member position request form for NAPRC

Applications will close on June 30, 2024 at 12pm CST. For any questions, please contact cpmembership@facs.org.
General Information

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* 1. Name and credentials

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* 2. ACS member ID number (if applicable/known)

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* 3. Institution/Organization

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* 5. Business phone

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* 6. Gender

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* 7. Race

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* 8. Ethnicity

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* 9. Specialty

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* 10. What other ACS Committees are you applying to? (You may apply up to 2)

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* 11. Please list other ACS committee(s) you currently serve on.

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* 12. Please attach a copy of your CV or biographical sketch. (PDF file)
*Please note, you are not required to share any sensitive information on your file.

PDF file types only.
Choose File

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* 13. Number of years as a practicing cancer professional after completion of training (enter 0 if you are still in training).

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* 14. Cancer discipline

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* 15. Areas of expertise and/or practice. (Check all that apply)

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* 16. Are you a member of any other cancer programs or cancer-related professional organizations? (Check all that apply)

Committee Interest

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* 17. Please select your Cancer Program of interest from the programs with committee member openings below.

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* 18. Please select your committee of interest. (Select only one)

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* 19. Please indicate which accreditation program your local institution participates in currently. (Check all that apply)

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* 20. Have you been a site reviewer? (Check all that apply)

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* 21. Have you been a local program leader of your accredited program? (Check all that apply)

Statement of Intent

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* 22. Describe relevant cancer activities that make you eligible and qualified to participate in this committee. (250 words)

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* 23. What contributions would you expect to make towards bringing Equity, Diversity, and Inclusion into the decision making and activities of the committee? (150 words)

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* 24. Describe other relevant activities that make you eligible and qualified to participate in this committee (i.e., work in the field of informatics, analytics, leadership, etc.). (150 words)

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