Membership Application

The following form will be used to gather information in order to process your membership application. Be sure to complete the entire form.

  • Membership Categories

    • Have a strong interest in reducing lung cancer morbidity and mortality
    • Have outstanding expertise and reputation in lung cancer information and research
    • Have special expertise in any of the following: lung cancer risk reduction, early detection, diagnosis, staging, treatment, stigma, or patient support
    • Can deliver lung cancer education to individuals with lung cancer and/or providers
    • Can deliver lung cancer screening services
    • Can deliver smoking cessation/tobacco treatment services