Member Applications

Fields marked with an * are required

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The Criteria For Membership Include:

A urological oncologist, radiation oncologist, or medical oncologist, with an interest in urological oncology research and clinical trials
Disclosure of Site Profile Information for CUOG data base
Abiding by CUOG Principles of Membership
No Annual Dues Fee.

First Name *

Last Name *

Hospital or University address *

Phone *

Email *

Fax

If available, please list Names of Referring CUOG Members(s):

Sub-specialty interest (check 1 or more): *

Practice *

Please include a brief note indicating your interest in joining the CUOG *

2000 of 2000 Character(s) left

I will upload my CV electronically *

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FOR FURTHER INFORMATION CONTACT:

Email CUOG Headquarters