BECOME A MEMBER OF APINCSN:

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Name *

Email *

Phone Number: *

Organization Name

State *

What activities would you like to participate in? *

I would like to:

Become a member of the APINCSN email listserv and obtain information on cancer-related issues, activities, and funding opportunities.

Call, visit, or write to policy makers

Speak with newly diagnosed AA, and/or NHPI cancer patients

Receive capacity building assistance and training

Participate in future APINCSN Community & Advocacy Training on Cancer & Health (CATCH) Leadership Program (policy advocacy, data advocacy, media communications, cancer support groups, AAs & NHPIs and cancer 101)

Participate in cancer related advisory boards, councils, or committees

Required

Are you interested in joining our APINCSN Action Teams? *

Action team members are volunteers that provide guidance to assist APINCSN in pursuing its mission, vision, and goals. Membership consists of individuals from the United States and Pacific Island Jurisdictions who provide APIAHF staff with recommendations on planning, implementing, and evaluating community-driven strategies to address cancer in our communities.

I would like to join the Policy Advocacy and Data Action Team

I would like to join the Survivorship Action Team

I would like to join the Training and Capacity Building Action Team

None of the above. I am currently not interested in joining the action teams.

Required

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