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 December 2nd, 2024. 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:

First Name *

Last Name *

Email *

Specialty *

Please Specify

Residency Location/Hospital *

Province *

Please Specify

Program Director *

Training Level PGY *

Please Specify

Have you attended TLC in the past? *

Yes No

Are you aware of the Betty Rice Award? *

For information on the Betty Rice Awards please click here.