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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. Schellenberg and Dr. Sangha, will confirm accepted candidates by mid-December. After receiving participation approval you will be requested to register for the Canadian Lung Cancer Conference. 

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
*Residency Location/Hospital
*Province
*Program Director
*Training Level PGY
*Have you attended TLC (CORE) in the past?    
*Are you aware of the Betty Rice Award?
For information on the Betty Rice Awards please click here.