Terms of Membership. Members can be individuals or organizations (such as local Cancer Coalitions, American Cancer Society). Members can choose to join a workgroup or to join as corresponding members to receive communication. Benefits of membership: • Collaboration throughout the state to increase impact and maximize resources • Regular updates on cancer control activities throughout Maryland • Avenues for networking across disciplines and organizations statewide • Access to educational resources and training opportunities Members agree to: • Be identified as a member of the Maryland Cancer Collaborative • Support and utilize the Cancer Plan • Participate in meetings regularly (except for corresponding members) • Take specific action to implement the goals, objectives, and strategies of the Cancer Plan • Support and participate in evaluation of implementation efforts • Report implementation efforts and progress to DHMH • Report in-kind contributions toward Maryland Cancer Collaborative activities, such as student volunteer time, donated meeting space, implementation efforts, etc. • Abide by and adhere to Approval Procedure for Communicating Beyond the Collaborative* • Abide by and adhere to Policy Ground Rules* • Bring available resources to the table (expertise, specific skills, educational materials, website and/or graphic design services, mailings, meeting rooms, student volunteers, etc.) *Available online at: xxxxx://xxx.xx/OvZMBF The Maryland Cancer Collaborative does not endorse or take positions on legislation, nor does it participate in any lobbying or advocacy activities. DATE: PLEASE INDICATE: Current Member New Member NAME: _ CREDENTIALS: TITLE: ORGANIZATION: ADDRESS: CITY/STATE/ZIP: COUNTY: PHONE: EMAIL: To help us track diversity of the Maryland Cancer Collaborative, please consider providing the following: RACE: African American White American Indian or Alaskan Native Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian (specify: ) Guamanian or Chamorro Native Hawaiian or Other Pacific Islander Samoan Other (specify: ) ETHNICITY: Hispanic or Latino Non-Hispanic or Latino PLEASE SELECT: Corresponding Member (would like to receive email communication only) OR Active Workgroup Member → Select workgroup(s) of interest: Tobacco Cessation HPV Vaccination Access to Care and Services Hospice Utilization Communications RESOURCES THAT YOU CAN CONTRIBUTE: Expertise in: Marketing/Media/Graphic Design Web Design Meeting space Financial Resources Other: My signature indicates that I agree with the terms of membership outlined in the Maryland Cancer Collaborative Member Agreement Form: RETURN FORM TO: XXXX XXXXXX, MARYLAND CANCER COLLABORATIVE 000 X. XXXXXXX, 3RD FLOOR, BALTIMORE, MD 21201
Appears in 1 contract
Samples: health.maryland.gov
Terms of Membership. Members can be individuals or organizations (such as local Cancer Coalitions, American Cancer Society). Members can choose to join a workgroup committee or to join as corresponding members to receive communication. Benefits of membership: • Collaboration throughout the state to increase impact and maximize resources • Regular updates on cancer control activities throughout Maryland • Avenues for networking across disciplines and organizations statewide • Access to educational resources and training opportunities Members agree to: • Be identified as a member of the Maryland Cancer Collaborative • Support and utilize the Cancer Plan • Participate in meetings regularly (except for corresponding members) • Take specific action to implement the goals, objectives, and strategies of the Cancer Plan • Support and participate in evaluation of implementation efforts • Report implementation efforts and progress to DHMH • Report in-kind contributions toward Maryland Cancer Collaborative activities, such as student volunteer time, donated meeting space, implementation efforts, etc. • Abide by and adhere to Approval Procedure for Communicating Beyond the Collaborative* • Collaborative Abide by and adhere to Policy Ground Rules* • Rules Bring available resources to the table (expertise, specific skills, educational materials, website and/or graphic design services, mailings, meeting rooms, student volunteers, etc.) *Available online at: xxxxx://xxx.xx/OvZMBF The Maryland Cancer Collaborative does not endorse or take positions on legislation, nor does it participate in any lobbying or advocacy activities. DATE: PLEASE INDICATE: Current Member New Member NAME: _ CREDENTIALS: TITLE: ORGANIZATION: ADDRESS: CITY/STATE/ZIP: COUNTY: PHONE: EMAIL: To help us track diversity of the Maryland Cancer Collaborative, please consider providing the following: RACE: African American White American Indian or Alaskan Native Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian (specify: ) Guamanian or Chamorro Native Hawaiian or Other Pacific Islander Samoan Other (specify: ) ETHNICITY: Hispanic or Latino Non-Hispanic or Latino PLEASE SELECT: Corresponding Member (would like to receive email communication only) OR Active Workgroup Committee Member → Select workgroup(scommittee(s) of interest: Tobacco Cessation HPV Vaccination Access to Care Primary Prevention Early Detection and Services Hospice Utilization Communications Treatment Evaluation Cancer Disparities Survivorship/Palliative Care/Pain Management Policy RESOURCES THAT YOU CAN CONTRIBUTE: Expertise in: Marketing/Media/Graphic Design Web Design Meeting space Financial Resources Other: My signature indicates that I agree with the terms of membership outlined in the Maryland Cancer Collaborative Member Agreement Form: RETURN FORM TO: XXXX XXXXXXXXXXXXXX XXXXX, MARYLAND COMPREHENSIVE CANCER COLLABORATIVE CONTROL PLAN 000 X. XXXXXXX, 3RD FLOOR, BALTIMORE, MD 21201
Appears in 1 contract
Samples: health.maryland.gov
Terms of Membership. Members can be individuals or organizations (such as local Cancer Coalitions, American Cancer Society). Members can choose to join a workgroup or to join as corresponding members to receive communication. Benefits of membership: • Collaboration throughout the state to increase impact and maximize resources • Regular updates on cancer control activities throughout Maryland • Avenues for networking across disciplines and organizations statewide • Access to educational resources and training opportunities Members agree to: • Be identified as a member of the Maryland Cancer Collaborative • Support and utilize the Cancer Plan • Participate in meetings regularly (except for corresponding members) • Take specific action to implement the goals, objectives, and strategies of the Cancer Plan • Support and participate in evaluation of implementation efforts • Report implementation efforts and progress to DHMH Maryland Department of Health • Report in-kind contributions toward Maryland Cancer Collaborative activities, such as student volunteer time, donated meeting space, implementation efforts, etc. • Abide by and adhere to Approval Procedure for Communicating Beyond the Collaborative* • Abide by and adhere to Policy Ground Rules* • Bring available resources to the table (expertise, specific skills, educational materials, website and/or graphic design services, mailings, meeting rooms, student volunteers, etc.) *Available online at: xxxxx://xxx.xx/OvZMBF The Maryland Cancer Collaborative does not endorse or take positions on legislation, nor does it participate in any lobbying or advocacy activities. DATE: PLEASE INDICATE: Current Member New Member NAME: _ _CREDENTIALS: TITLE: ORGANIZATION: ADDRESS: CITY/STATE/ZIP: COUNTY: :_ PHONE: EMAIL: To help us track diversity of the Maryland Cancer Collaborative, please consider providing the following: RACE: African American White American Indian or Alaskan Native Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian (specify: ) Guamanian or Chamorro Native Hawaiian or Other Pacific Islander Samoan Other (specify: ) ETHNICITY: Hispanic or Latino Non-Hispanic or Latino PLEASE SELECTPLEASESELECT: Corresponding Member (would like to receive email communication only) OR Active Workgroup Member → Select workgroup(s) of interest: Tobacco Cessation HPV Vaccination HPVVaccination Access to Care and Services Hospice Utilization Communications RESOURCES THAT YOU CAN CONTRIBUTE: Expertise in: Marketing/Media/Graphic Design Web Design Meeting space Financial Resources FinancialResources Other: My signature indicates that I agree with the terms of membership outlined in the Maryland Cancer Collaborative Member Agreement Form: RETURN FORM TO: XXXX XXXXXXXXXXX, MARYLAND CANCER COLLABORATIVE CANCERCOLLABORATIVE 000 X. XXXXXXX, 3RD FLOOR, BALTIMORE, MD 21201
Appears in 1 contract
Samples: test-health.maryland.gov
Terms of Membership. Members can be individuals or organizations (such as local Cancer Coalitions, American Cancer Society). Members can choose to join a workgroup or to join as corresponding members to receive communication. Benefits of membership: • Collaboration throughout the state to increase impact and maximize resources • Regular updates on cancer control activities throughout Maryland • Avenues for networking across disciplines and organizations statewide • Access to educational resources and training opportunities Members agree to: • Be identified as a member of the Maryland Cancer Collaborative • Support and utilize the Cancer Plan • Participate in meetings regularly (except for corresponding members) • Take specific action to implement the goals, objectives, and strategies of the Cancer Plan • Support and participate in evaluation of implementation efforts • Report implementation efforts and progress to DHMH Maryland Department of Health • Report in-kind contributions toward Maryland Cancer Collaborative activities, such as student volunteer time, donated meeting space, implementation efforts, etc. • Abide by and adhere to Approval Procedure for Communicating Beyond the Collaborative* • Abide by and adhere to Policy Ground Rules* • Bring available resources to the table (expertise, specific skills, educational materials, website and/or graphic design services, mailings, meeting rooms, student volunteers, etc.) *Available online at: xxxxx://xxx.xx/OvZMBF The Maryland Cancer Collaborative does not endorse or take positions on legislation, nor does it participate in any lobbying or advocacy activities. DATE: PLEASE INDICATE: Current Member New Member NewMember NAME: _ CREDENTIALS: TITLE: ORGANIZATION: ADDRESS: CITY/STATE/ZIP: COUNTY: :_ PHONE: EMAIL: To help us track diversity of the Maryland Cancer Collaborative, please consider providing the following: RACE: African American White American Indian or Alaskan Native Asian Indian AsianIndian Chinese Filipino Japanese Korean Vietnamese Other Asian (specify: ) Guamanian or Chamorro Native Hawaiian or Other Pacific Islander Samoan Other (specifyOther(specify: ) ETHNICITY: Hispanic or Latino Non-Hispanic or Latino PLEASE SELECTPLEASESELECT: Corresponding Member (would like to receive email communication only) OR Active Workgroup Member → Select workgroup(s) of interest: □ Tobacco Cessation HPV Vaccination Access Support to Care and Services Hospice Utilization Providers □ HPV-Cancer Awareness □ Cancer Survivorship Education □ Communications - Lesser Known Cancer Risk Factors □ High-Risk Population Targeted Outreach RESOURCES THAT YOU CAN CONTRIBUTEYOUCANCONTRIBUTE: Expertise inExpertisein: Marketing/Media/Graphic Design Web Design Meeting space Meetingspace Financial Resources Other: My signature indicates that I agree with the terms of membership outlined in the Maryland Cancer Collaborative Member Agreement Form: RETURN FORM RETURNFORM TO: XXXX XXXXXX, MARYLAND CANCER COLLABORATIVE SARAVALEK MARYLANDCANCERCOLLABORATIVE 000 X. XXXXXXX, 3RD FLOOR, BALTIMORE, MD 21201
Appears in 1 contract
Samples: health.maryland.gov
Terms of Membership. Members can be individuals or organizations (such as local Cancer Coalitions, American Cancer Society). Members can choose to join a workgroup or to join as corresponding members to receive communication. Benefits of membership: • Collaboration throughout the state to increase impact and maximize resources • Regular updates on cancer control activities throughout Maryland • Avenues for networking across disciplines and organizations statewide • Access to educational resources and training opportunities Members agree to: • Be identified as a member of the Maryland Cancer Collaborative • Support and utilize the Cancer Plan • Participate in meetings regularly (except for corresponding members) • Take specific action to implement the goals, objectives, and strategies of the Cancer Plan • Support and participate in evaluation of implementation efforts • Report implementation efforts and progress to DHMH Maryland Department of Health • Report in-kind contributions toward Maryland Cancer Collaborative activities, such as student volunteer time, donated meeting space, implementation efforts, etc. • Abide by and adhere to Approval Procedure for Communicating Beyond the Collaborative* • Abide by and adhere to Policy Ground Rules* • Bring available resources to the table (expertise, specific skills, educational materials, website and/or graphic design services, mailings, meeting rooms, student volunteers, etc.) *Available online at: xxxxx://xxx.xx/OvZMBF The Maryland Cancer Collaborative does not endorse notendorse or take positions on legislation, nor does it participate in any lobbying or advocacy activities. DATE: PLEASE INDICATE: Current Member New Member NewMember NAME: _ CREDENTIALS: TITLE: ORGANIZATION: ADDRESS: CITY/STATE/ZIP: COUNTY: :_ PHONE: EMAIL: To help us track diversity of the Maryland Cancer Collaborative, please consider providing the following: RACE: African American White American Indian or Alaskan Native Asian Indian AsianIndian Chinese Filipino Japanese Korean Vietnamese Other Asian (specifyAsian(specify: ) Guamanian or Chamorro Native Hawaiian or Other Pacific Islander Samoan Other (specifyOther(specify: ) ETHNICITY: Hispanic or Hispanicor Latino Non-Hispanic or Hispanicor Latino PLEASE SELECTPLEASESELECT: Corresponding Member (would like to receive email communication emailcommunication only) OR Active Workgroup Member → Select workgroup(s) of interest: □ Tobacco Cessation HPV Vaccination Access Support to Care and Services Hospice Utilization Providers □ HPV-Cancer Awareness □ Cancer Survivorship Education □ Communications RESOURCES THAT YOU CAN CONTRIBUTE- Lesser Known Cancer Risk Factors □ Cancer Survivorship Education RESOURCESTHATYOUCANCONTRIBUTE: Expertise inExpertisein: Marketing/Media/Graphic Design Web Design Meeting space Meetingspace Financial Resources Other: My signature indicates that I agree with the terms of membership outlined in the Maryland Cancer Collaborative Member Agreement Form: RETURN FORM RETURNFORM TO: XXXX XXXXXX, XXXXX MARYLAND CANCER COLLABORATIVE 000 X. XXXXXXX, 3RD FLOOR, BALTIMORE, MD 21201
Appears in 1 contract
Samples: health.maryland.gov
Terms of Membership. Members can be individuals or organizations (such as local Cancer Coalitions, American Cancer Society). Members can choose to join a workgroup or to join as corresponding members to receive communication. Benefits of membership: • Collaboration throughout the state to increase impact and maximize resources • Regular updates on cancer control activities throughout Maryland • Avenues for networking across disciplines and organizations statewide • Access to educational resources and training opportunities Members agree to: • Be identified as a member of the Maryland Cancer Collaborative • Support and utilize the Cancer Plan • Participate in meetings regularly (except for corresponding members) • Take specific action to implement the goals, objectives, and strategies of the Cancer Plan • Support and participate in evaluation of implementation efforts • Report implementation efforts and progress to DHMH • Report in-kind contributions toward Maryland Cancer Collaborative activities, such as student volunteer time, donated meeting space, implementation efforts, etc. • Abide by and adhere to Approval Procedure for Communicating Beyond the Collaborative* • Abide by and adhere to Policy Ground Rules* • Bring available resources to the table (expertise, specific skills, educational materials, website and/or graphic design services, mailings, meeting rooms, student volunteers, etc.) *Available online at: xxxxx://xxx.xx/OvZMBF The Maryland Cancer Collaborative does not endorse or take positions on legislation, nor does it participate in any lobbying or advocacy activities. DATE: PLEASE INDICATE: Current Member New Member NAME: _ CREDENTIALS: TITLE: ORGANIZATION: ADDRESS: CITY/STATE/ZIP: COUNTY: :_ PHONE: EMAIL: To help us track diversity of the Maryland Cancer Collaborative, please consider providing the following: RACE: African American White American Indian or Alaskan Native Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian (specify: ) Guamanian or Chamorro Native Hawaiian or Other Pacific Islander Samoan Other (specify: ) ETHNICITY: Hispanic or Latino Non-Hispanic or Latino PLEASE SELECT: Corresponding Member (would like to receive email communication only) OR Active Workgroup Member → Select workgroup(s) of interest: Tobacco Cessation HPV Vaccination Access to Care and Services Hospice Utilization Communications RESOURCES THAT YOU CAN CONTRIBUTE: Expertise in: Marketing/Media/Graphic Design Web Design Meeting space Financial Resources Other: My signature indicates that I agree with the terms of membership outlined in the Maryland Cancer Collaborative Member Agreement Form: RETURN FORM TO: XXXX XXXXXXXXXXX, MARYLAND CANCER COLLABORATIVE 000 X. XXXXXXX, 3RD FLOOR, BALTIMORE, MD 21201
Appears in 1 contract
Samples: health.maryland.gov
Terms of Membership. Members can be individuals or organizations (such as local Cancer Coalitions, American Cancer Society). Members can choose to join a workgroup or to join as corresponding members to receive communication. Benefits of membership: • Collaboration throughout the state to increase impact and maximize resources • Regular updates on cancer control activities throughout Maryland • Avenues for networking across disciplines and organizations statewide • Access to educational resources and training opportunities Members agree to: • Be identified as a member of the Maryland Cancer Collaborative • Support and utilize the Cancer Plan • Participate in meetings regularly (except for corresponding members) • Take specific action to implement the goals, objectives, and strategies of the Cancer Plan • Support and participate in evaluation of implementation efforts • Report implementation efforts and progress to DHMH Maryland Department of Health • Report in-kind contributions toward Maryland Cancer Collaborative activities, such as student volunteer time, donated meeting space, implementation efforts, etc. • Abide by and adhere to Approval Procedure for Communicating Beyond the Collaborative* • Abide by and adhere to Policy Ground Rules* • Bring available resources to the table (expertise, specific skills, educational materials, website and/or graphic design services, mailings, meeting rooms, student volunteers, etc.) *Available online at: xxxxx://xxx.xx/OvZMBF The Maryland Cancer Collaborative does not endorse or take positions on legislation, nor does it participate in any lobbying or advocacy activities. DATE: PLEASE INDICATE: Current Member New Member NewMember NAME: _ CREDENTIALS: TITLE: ORGANIZATION: ADDRESS: CITY/STATE/ZIP: COUNTY: :_ PHONE: EMAIL: To help us track diversity of the Maryland Cancer Collaborative, please consider providing the following: RACE: African American White American Indian or Alaskan Native Asian Indian AsianIndian Chinese Filipino Japanese Korean Vietnamese Other Asian (specify: ) Guamanian or Chamorro Native Hawaiian or Other Pacific Islander Samoan Other (specifyOther(specify: ) ETHNICITY: Hispanic or Latino Non-Hispanic or Latino PLEASE SELECTPLEASESELECT: Corresponding Member (would like to receive email communication only) OR Active Workgroup Member → Select workgroup(s) of interest: □ Tobacco Cessation HPV Vaccination Access Support to Care and Services Hospice Utilization Providers □ HPV-Cancer Awareness □ Cancer Survivorship Education □ Communications - Lesser Known Cancer Risk Factors □ High-Risk Population Targeted Outreach RESOURCES THAT YOU CAN CONTRIBUTEYOUCANCONTRIBUTE: Expertise inExpertisein: Marketing/Media/Graphic Design Web Design Meeting space Meetingspace Financial Resources Other: My signature indicates that I agree with the terms of membership outlined in the Maryland Cancer Collaborative Member Agreement Form: RETURN FORM RETURNFORM TO: XXXX XXXXXX, MARYLAND CANCER COLLABORATIVE XXXXXX MARYLANDCANCERCOLLABORATIVE 000 X. XXXXXXX, 3RD FLOOR, BALTIMORE, MD 21201
Appears in 1 contract
Samples: phpa.health.maryland.gov
Terms of Membership. Members can be individuals or organizations (such as local Cancer Coalitions, American Cancer Society). Members can choose to join a workgroup or to join as corresponding members to receive communication. Benefits of membership: • Collaboration throughout the state to increase impact and maximize resources • Regular updates on cancer control activities throughout Maryland • Avenues for networking across disciplines and organizations statewide • Access to educational resources and training opportunities Members agree to: • Be identified as a member of the Maryland Cancer Collaborative • Support and utilize the Cancer Plan • Participate in meetings regularly (except for corresponding members) • Take specific action to implement the goals, objectives, and strategies of the Cancer Plan • Support and participate in evaluation of implementation efforts • Report implementation efforts and progress to DHMH Maryland Department of Health • Report in-kind contributions toward Maryland Cancer Collaborative activities, such as student volunteer time, donated meeting space, implementation efforts, etc. • Abide by and adhere to Approval Procedure for Communicating Beyond the Collaborative* • Abide by and adhere to Policy Ground Rules* • Bring available resources to the table (expertise, specific skills, educational materials, website and/or graphic design services, mailings, meeting rooms, student volunteers, etc.) *Available online at: xxxxx://xxx.xx/OvZMBF The Maryland Cancer Collaborative does not endorse or take positions on legislation, nor does it participate in any lobbying or advocacy activities. DATE: PLEASE INDICATE: Current Member New Member NAME: _ CREDENTIALS: TITLE: ORGANIZATION: ADDRESS: CITY/STATE/ZIP: COUNTY: :_ PHONE: EMAIL: To help us track diversity of the Maryland Cancer Collaborative, please consider providing the following: RACE: African American White American Indian or Alaskan Native Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian (specify: ) Guamanian or Chamorro Native Hawaiian or Other Pacific Islander Samoan Other (specify: ) ETHNICITY: Hispanic or Latino Non-Hispanic or Latino PLEASE SELECTPLEASESELECT: Corresponding Member (would like to receive email communication only) OR Active Workgroup Member → Select workgroup(s) of interest: Tobacco Cessation HPV Vaccination HPVVaccination Access to Care and Services Hospice Utilization Communications RESOURCES THAT YOU CAN CONTRIBUTE: Expertise in: Marketing/Media/Graphic Design Web Design Meeting space Financial Resources FinancialResources Other: My signature indicates that I agree with the terms of membership outlined in the Maryland Cancer Collaborative Member Agreement Form: RETURN FORM TO: XXXX XXXXXXXXXXX, MARYLAND CANCER COLLABORATIVE CANCERCOLLABORATIVE 000 X. XXXXXXX, 3RD FLOOR, BALTIMORE, MD 21201
Appears in 1 contract
Samples: health.maryland.gov