Title: (required)
MrMrsMsMissDrProf

First Name: (required)

Surname: (required)

Organisation: (required)

Job title: (required)

Email: (required)

Contact number: (required)

Have you ever been a member of the NCRI Cancer Conference Scientific Committee? If yes, which year? (required)
NoYes

Please select your major focus:(tick all that apply) (required)
Basic science / Non-clinical researchBehavioural scienceBusiness developmentClinical research / clinical practiceConsumer / Patient expertIndustryPopulation scienceResearch administrationScience educationTranslational researchOther: please specify

Please select your expertise: (tick all that apply) (required)
Behavioural scienceBiochemistryBioinformatics and computational biologyCarcinogenesisCell biologyChemistryClinical research / clinical trialsDiagnostics and biomarkersEndocrinologyEpidemiologyEpigeneticsExperimental and molecular therapeuticsGeneticsGenomics/Proteomics/-OmicsGeriatric oncologyHealth economicsHealth servicesImagingImmunology and immuno-oncologyMolecular biologyPaediatric oncologyPalliative, supportive and end of life carePathologyPharmacologyPolicyPrevention researchPsychosocial oncologyRadiation science and medicine / radiotherapyScreening and early detectionStatisticsSurgical oncologySurvivorship research / Living with and beyondSystems biologyTeenage and young adults researchTranslational researchTumour biologyVirologyOther: (please specify)

If relevant, please select the cancer site you specialise in: (tick all that apply)
Bladder and renalBrainBreastColorectalGynaecologicalHaematologicalHead and neckLeukaemiaLungLymphomaMelanomaProstateSarcomaSkinTestisUpper GIN/AOther: Please specify

Your expertise may cut across all, or several, of the following Conference streams but please select which sub-committee you would like to apply for:
Cancer discovery / underpinning researchPrevention, early detection, diagnosis and prognosisTreatmentCancer control, living with and beyond and cancer outcomes

Please select which position you are applying for:
LeadVice-leadMemberTrainee/Junior scientistPatient repIndustry repClinical Studies Group rep or other NCRI Committee rep (*please note to apply for this position you must be an existing member of an NCRI group)

To help with the shortlisting process, please tell us why you would like to be a Scientific Committee member for the NCRI Cancer Conference and what experience / expertise you will bring to the Committee? (Max 300 words)

Please tick to confirm you have read and understood the Scientific Committee's roles and responsibilities.

Add CV