Basic information for all membership categories
Name:
Degree (MD, PhD, etc):
Department of Primary Academic
Appointment:
Slot #:
Academic Rank as of July
1, 2006:
Professor and Chair
Professor
Associate Professor
Assistant Professor
Adjunct Associate Professor
Research Professor
Research Associate Professor
Research Assistant Professor
Research Scientist
Instructor
Telephone #:
Fax #:
E-mail Address:
Space Assignment:
damiles@uams.edu ).Submissions without an accompanying CV and NIH Biosketch
CANNOT be considered.
Please click on the appropriate category of membership for which you
are applying (click
here for an explanation of the various memberships ):
Research Membership Contributing
Membership
Clinical Membership Affiliate Membership
Information needed
for Research Membership ONLY:
1. State your research interests.
State your research interests.
Describe your leadership title and role in the Cancer Institute.
Cancer Institutes
research programs , identified at right (check all that apply)
Please
scroll down to Submit
Information needed
for Contributing Membership ONLY:
1. State your research interests.
State your research interests.
State your research interests.
Cancer Institutes
research programs , identified at right
(check all that apply)
Please
scroll down to Submit
Information needed
for Clinical Membership ONLY:
1. State your
clinical interests and % effort.
Cancer Institutes
research programs , identified at right
(check all that apply)
Please
scroll down to Submit
Information needed
for Affiliate Membership ONLY:
1. State your professional focus.
State your professional focus.
Please
scroll down to Submit
Cancer Institutes
research programs , identified at right
(check all that apply)
