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 representatives in NSW, ACT and SA. Fill in the form below by 5pm (AEDT) Friday 18 December 2020 to confirm 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?

Job title 1:

Employer 1:

Job title 2:

Employer 2:

Question Title

* 3. Please provide your best contact details

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 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)

Question Title

* 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:

Question Title

* 6. Do you have any training in progress?

Yes

if Yes, please provide details and expected completion date

Question Title

* 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:

Question Title

* 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

PDF, DOC, DOCX file types only.

Choose File

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

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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?