Join the ANZ-LCNF Steering Committee!

Submit your Expression of Interest

Are you passionate about patient care in lung cancer and want to bring your experience to a national level? Do you want to support and develop the lung cancer nursing profession?

We currently have vacancies on the ANZ-LCNF Steering Committee for QLD and VIC state representatives and nurse practitioner and nurse researcher representatives. To submit your interest, please complete the form below.

Question Title

* 1. What is your full name?

Question Title

* 2. What is your current position/s within thoracic oncology nursing?

Job title 1:

Employer 1:

Job title 2:

Employer 2:

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* 3. Please provide your best contact details

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 4. Please select your areas of experience and expertise

Registered Nurse

Enrolled Nurse

Lung Cancer Nurse Coordinator

Lung Cancer Nurse Specialist

Cancer Care Coordinator / Nurse

Chemo / Oncology (Competent) Nurse

Radiation Nurse

Support Group Facilitator / Peer Support

Survivorship Care

Nurse Practitioner

Nurse Researcher

Other (please specify)

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* 5. Please provide detail on your formal qualifications (complete additional rows as required)

Title:

Year of Completion:

Institution:

Title:

Year of Completion:

Institution:

Title:

Year of Completion:

Institution:

Title:

Year of Completion:

Institution:

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* 6. Do you have any training in progress?

Yes

if Yes, please provide details and expected completion date

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* 7. Please provide a recent work history (up to 5 years) relevant to thoracic oncology nursing

Job title 1:

Employer 1:

Job title 2:

Employer 2:

Job title 3:

Employer 3:

Job title 4:

Employer 4:

Job title 5:

Employer 5:

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* 8. Please provide your professional endorsements on employer / institution letterhead

Examples of professional endorsements include; Nurse Director, a Lead MDT Clinician at your hospital, Research Supervisor

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Question Title

* 9. Written response:
What motivates you to join the ANZ-LCNF Steering Committee?
What difference do you hope to make to thoracic oncology nursing?

1 page max, 10 point Century Gothic font

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Join the ANZ-LCNF Steering Committee!

Submit your Expression of Interest

Question Title

* 1. What is your full name?

Question Title

* 2. What is your current position/s within thoracic oncology nursing?

Question Title

* 3. Please provide your best contact details

Question Title

* 4. Please select your areas of experience and expertise

Question Title

* 5. Please provide detail on your formal qualifications (complete additional rows as required)

Question Title

* 6. Do you have any training in progress?

Question Title

* 7. Please provide a recent work history (up to 5 years) relevant to thoracic oncology nursing

Question Title

* 8. Please provide your professional endorsements on employer / institution letterhead

Question Title

* 9. Written response:What motivates you to join the ANZ-LCNF Steering Committee? What difference do you hope to make to thoracic oncology nursing?

Question Title

* 10. Is there anything else you would like us to know?

* 9. Written response:
What motivates you to join the ANZ-LCNF Steering Committee?
What difference do you hope to make to thoracic oncology nursing?