Hei Āhuru Mōwai Membership
Expression of Interest
Name
*
First Name
Last Name
Title/s
Professional (i.e. Dr, Professor, Boards you chair, etc)
Other distinctions (i.e. qualifications, ONZM, etc)
Email address
*
Your preferred email address to receive Member communications
Contact number
-
Area Code
Phone Number
Postal address
Postal Address Line 1
Postal Address Line 2
City
Postcode
Region
What is your ethnicity?
*
1 European
2 Māori
3 Pacific Peoples
4 Asian
5 Middle Eastern/Latin American/African
6 Other Ethnicity*
9 Prefer not to disclose
Iwi affiliation/s (if of Māori descent)
Please separate each iwi named with a comma e.g. Ngati Raukawa, Ngai Tahu.
Membership type - please select one of our three options
*
Please Select
Professional membership Option 1 - whānau connected to organisations will be asked to contribute $200 per annum.
Professional Membership Option 2 - whānau who receive CME will be asked to contribute an agreed proportion of their CME.
Kaupapa Membership (koha basis only). There is no expectation on individual members to provide koha.
Note: all non-Māori members will be automatically registered as Kaupapa Members.
Pūkenga and Mātauranga
Tell us your area/s of cancer research expertise we can record on our database.
Kaupapa of Interest
Tell us any kaupapa you'd like to hear more about - may or may not be related to your area/s of expertise.
Please indicate which 'Pae' you would like to be involved with. You may choose to be involved with more than one.
Pae Rangahau - Expert research rōpū
Pae Ārai Puku - Expert prevention, early diagnosis and screening rōpū
Pae Haumanu - Expert treatment, clinical, service delivery rōpū
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