Cancer
consumer group
Cancer
support group
Carers
group
Professional
body
Health
care institution
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Cancer
Voices NSW |
| Mail to: | Cancer Voices NSW PO Box 5016 Greenwich NSW 2065 |
| 1. Group Membership |
| A | Member |
Cancer
consumer group
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Cancer
support group
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| B | Associate Member |
Carers
group
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Professional
body
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Health
care institution
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| Other (please specify) | |||||
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| Organisation Details |
| Contact person | Position |
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| Name of organisation |
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| Postal Address |
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| Suburb | City | State | Postcode |
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| Phone (day) | (evening) | (mobile) | |
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| Fax | Website | ||
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| Number of members in your organisation | |||
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| 2. Individual Membership (Associate) |
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Cancer
survivor
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Cancer
patient
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Family
member
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Carer
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Health
professional
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| Other (please specify) | |||||
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| Type of cancer experienced | |||||
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| Year(s) experienced | |||||
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| Personal Details |
| Title | First Name | Surname |
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| Postal Address |
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| Suburb | City | State | Postcode |
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| Occupation |
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| Phone (day) | (evening) | (mobile) | |
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| Fax |
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Male
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Female
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| Age group | |||
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18-29
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30-49
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50-69
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70+
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| 3. What skills could you contribute to Cancer Voices? |
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Administrative
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Communications
and media
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Representational
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Fundraising
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Policy
development
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Newsletter/website
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| Other (please specify) | |||||
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| 4. Consumer training |
| The Cancer Consumer Advocacy Training course offers skills and confidence for cancer consumers interested in being consumer representatives or advocates on behalf of Cancer Voices NSW. It is held several times a year, for two days (Friday and Saturday) in metropolitan and regional centres. This is an initiative of Cancer Voices and is provided by The Cancer Council NSW. An expression of interest form for the course can be sent to you by contacting Meagan Lawson on 02 9334 1850 or via email - meaganl@nswcc.org.au |
| 5. Donations |
| Cancer Voices NSW is entirely dependent on donations to operate. There is no fee to join, but we suggest a donation of $30 for groups and $10 for individuals. Any donation will help the VOICE to be heard. Please mail cheques or postal orders (Made payable to Cancer Voices NSW) with this application form and, if a receipt is required, please also enclose a stamped, self-addressed envelope. Tax deductible gift status is not available at this stage. | |
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Contribution
Amount: $
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| 6. What issues would you like to flag as a Cancer Voices NSW member? |
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| 7. Completed forms |
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Please post completed
forms to: |
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After
printing, close this window to return to the Cancer Voices NSW Website
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© 2002-2007
Cancer Voices Inc. NSW (CVN) |