Consumer Community Application

Consumer Community application
  • Personal details

  • Demographic Information

    We are seeking people from diverse backgrounds and locations.
  • Please choose which location you spend most of your time
  • Please tick which best applies to your current circumstances
  • Briefly outline your occupation or interests, including previous roles if now retired or not currently employed.
  • Experience

  • Have you had previous experience as a cancer consumer?
  • Are you currently a member of any other cancer research groups or consumer organisations?
  • If yes, please provide details (name of group/s, your role and recent activities)
  • Please describe any committee or working group experience you have not described above (it doesn’t have to be related to cancer).
  • Select those that refer to your situation
  • If other, please describe
  • Are there any research areas you are more interested in? Please select all that apply
  • Life skills - personal and professional

    People develop many skills from work, social, personal and family experiences. Please think broadly when you answer these questions.
  • Please describe how your life skills may contribute to our research activities.
  • Effective communication is key to being an effective representative. Please outline what you feel are your strengths in terms of communication.
  • Availability to participate

  • I am interested in...(please select all that apply)
  • Referees

    Please nominate a referee we can contact to discuss your application. These can be professional or personal and should be able to provide us with insight on how you might contribute should your application be successful.
  • Referee 1

  • Thank you

    Thank you for your application.