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TLC Application

Please note: Once you have applied for TLC your name will be submitted to the TLC Chairs for consideration. TLC Chairs, Dr. Sangha and Dr. Baker, will confirm accepted candidates by mid-December. After receiving participation approval, you will be requested to register for the Canadian Lung Cancer Conference as well.
This application IS NOT a registration form for the Cdn Lung Cancer Conference

Please contact HayMatick at info@haymatick.com for any questions regarding this application.

APPLICANT INFORMATION: (* = required field) *First Name *Last Name   *Email   *Specialty Med Onc Rad Onc Thoracics Other *Please specify *Residency Location/Hospital *Province Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Non USA / Canada *Program Director *Training Level PGY 123456 *Have you attended TLC in the past?   YES   NO *If yes, what years? *Are you aware of the Betty Rice Award? For information on the Betty Rice Awards please click here.   YES   NO Submit Application