UVM Cancer Center Member Application

Membership Application

To apply for University of Vermont Cancer Center (UVMCC) membership, please submit the application below (note: you will be asked to upload your NIH biosketch at the end).

Contact Kate Webster, Executive Director of Administration by email at kate.webster@med.uvm.edu with questions. More information about UVMCC membership can be found here.

Membership Type

Member

Trainee Member

Are you affiliated with the University of Vermont?

Yes

No

Note: If Trainee members do not have an ORCID ID, you must register here (opens in new window.) To learn why this is important click here (opens in new window.)

Once complete, please enter your ORCID ID (four groups of four digits separated by hyphens) below.

Trainee members must also complete their Monicur profile (link opens in new window) before submitting their member application.

Once complete, please enter your Monicur ID (a six digit alphanumeric string) below to gain access to the remainder of this application. Your Monicur ID can be found on your Monicur dashboard directly below your name in the top left corner.

Enter your ORCID ID (required):

Enter your Monicur ID (required):

I have provided my ORCID ID and Monicur ID above.

Contact Information

First Name:

Last Name:

Non-Affiliated Organization

NetID:
Please note this is different from your student ID number that begins with 95

We have the following information currently on file for you:

Email: none provided (required)
Office Phone: none provided (this will be visible on the Member Directory)
Website: none provided

Would you like to make changes?

We have the following information currently on file for you:

Email: none provided (required)
Office Phone: none provided (this will be visible on the Member Directory)
Website: none provided

Would you like to make changes?

Yes

No

(required) Preferred Email:

Preferred Office Phone:
(this will be visible on the Member Directory)

(optional) Professional Website:

Trainee Member Details

Current Education Level:

Undergraduate Student

Medical Student

Graduate Student

Post-Doctoral Fellow

Please indicate your PI or mentor:

Please describe your work with the above PI/mentor:

Key areas of interest/focus (choose all that apply):

Laboratory research

Population health and behavioral research

Clinical research

Are you interested in speaking with a Cancer Center member who could serve as a mentor?

Yes

No

Related Cancer Center Research and Activities

We have the following information currently on file for you:

Your appointed leadership or mentorship roles:

none provided

Your national awards or fellowships:

none provided

Your scholarly works::

none provided

Your community outreach activities:

none provided

Would you like to provide new information?*

Yes

No

Do you currently hold any leadership or mentorship roles (formal or informal) within professional organizations, your institution, or training programs?
Examples: committee roles, peer mentoring, organizing trainee events.

Yes

No

Dates (e.g. September 2025 - March 2026)*

Please briefly describe those positions.*

In the past year, have you received any awards, fellowships, or recognitions at the institutional, regional, national, or international level?
Examples: travel awards, poster prizes, trainee awards, departmental honors.

Yes

No

Please briefly describe those awards.*

Dates (e.g. September 2025 - March 2026)*

Have you presented or published any scholarly work at any conferences or institutional events in the past year?
Examples: journal articles, abstracts, oral presentations, posters.

Yes

No

Please briefly describe your scholarly work.*

Dates (e.g. September 2025 - March 2026)*

Have you contributed to any community outreach or advocacy efforts across the state of VT?

Yes

No

Please briefly describe any community outreach activities.*

Dates (e.g. September 2025 - March 2026)*

Member Details

We have the following information currently on file for you:

Primary Title:
none listed

Secondary Titles:
none listed

Degree(s):

Would you like to make changes?

We have the following information currently on file for you:

Primary Title:
none listed

Secondary Titles:
none listed

Degree(s):

Would you like to make changes?

Yes

No

Academic/Professional Primary Title
e.g. Associate Professor, Surgery

Academic/Professional Secondary Title(s)
e.g. Professor, Pulmonary & Critical Care Clinical
Professor, General Medicine

Degree(s)
e.g. MD

Demographics

Because the UVMCC is committed to inclusive excellence, we are collecting demographic information for our leadership and membership.

What is your ethnicity?

Hispanic or Latino

Not Hispanic nor Latino

Prefer not to answer

What is your race? (check all that apply)

If other, please specify (optional)

Do you identify as someone who has a disability?

Yes

No

Prefer not to answer

Are you a first-generation college student?

Yes

No

Prefer not to answer

Were you raised in a rural setting?

Yes

No

Prefer not to answer

Do you speak a language other than English?

Yes

No

If other, please specify:

Relevant Cancer Related Activities

We have the following information currently on file for you:

Your cancer related research, clinical research, or cancer care activities:

none provided

Your shortened (directory profile) research description:

none provided

Your community outreach activities:

none provided

Your appointed leadership or mentorship positions in a professional organizations:

none provided

Your membership on an editorial board:

none provided

Your national awards or fellowships:

none provided

Would you like to make changes?

We have the following information currently on file for you:

Your cancer related research, clinical research, or cancer care activities:

none provided

Your shortened (directory profile) research description:

none provided

Your community outreach activities:

none provided

Your appointed leadership or mentorship positions in a professional organizations:

none provided

Your membership on an editorial board:

none provided

Your national awards or fellowships:

none provided

Would you like to make changes?

Yes

No

Please describe your cancer related research, clinical research, or cancer care activities.

Please provide a condensed description of your research/work that you detailed above. This description will appear on your Cancer Center profile page. We encourage you to use terminology that would be appropriate for a general audience. Many use this space to provide information regarding postdoctoral training, other education, citations for cancer relevant work and/or links to publications.

Please briefly describe any community outreach activities. (optional)

Do you currently hold any appointed leadership or mentorship positions in a professional organization?

Yes

No

Please briefly describe those positions.*

Dates (e.g. September 2025 - March 2026)*

Do you currently have a membership on an editorial board?

Yes

No

Please briefly describe those memberships.*

Dates (e.g. September 2025 - March 2026)*

In the past year, have you received any national awards or fellowships?

Yes

No

Please briefly describe those awards.*

Dates (e.g. September 2025 - March 2026)*

Upload NIH Biosketch

Please upload your NIH Biosketch. A new NIH Biosketch is required this year for all Full, Associate, and Core Clinical members.

A new NIH Biosketch is required this year for all Full, Associate, and Core Clinical members. Upload your NIH Biosketch if desired.

If you would like to upload Other Support information please do so here:

Upload/Review Member Directory Photo

We are currently using the following image in our member directory:

Would you like to upload a new image?

We are currently using the following image in our member directory:

Would you like to upload a new image?

Yes

No

Upload your headshot (optional)

UVM Cancer Center Research Program Identification

Please indicate the UVMCC research program that you may feel is best aligned with your research and clinical expertise; each program area includes basic, clinical, and translational cancer research. For descriptions of programs, please refer to the UVMCC website research programs page.

Cancer Cell (CC)

Cancer Host and Interactions (CHI)

Population Sciences and Cancer Outcomes (PSCO)

Key Areas of Interest/Focus

We have the following information currently on file for you:

Would you like to make changes?

We have the following information currently on file for you:

Would you like to make changes?

Yes

No

Use your CTRL key (COMMAND key on a Mac) to select multiple detailed areas of focus:

Clinical Trials Participation

Are you now, or have you previously been involved in clinical trials research?

Yes

No

Training and Mentoring

Do you currently have trainees of any level (undergraduate, graduate, or medical student or research or clinical fellow) as part of your research program?

Yes

No

Please provide their name(s):

Are you recruiting/accepting new trainees into your research program in the next year?

Yes

No

Indicate your interest in training and mentoring (choose all that apply).

I am interested in accepting summer students.

I am interested in being a mentor for a trainee.

I am looking for graduate students for my research program.

Are you interested in being matched with a student participating in the UVMCC Summer Student Fellowship Program?

Yes

No

BSN
BS
BA
MD
DO
PhD
DVM
PharmD
PsyD
DNP
FACS
FACOS
FRCS©
OCN
RN
PT
RD
CCC-SLP
CGC
MPH
MBA
MPA
MHS
MS
MSc
MSHS
MDP

Bladder cancer
Brain cancer
Breast cancer
Colon cancer
Esophageal/stomach cancer
GYN oncology
Head & neck cancer
Hematologic malignancies
Liver/pancreatic cancer
Lung cancer
Melanoma/sarcoma
Pediatric oncology
Prostate cancer
Thyroid and endocrine cancers
Cancer genetics
Cancer immunology
DNA damage/repair
Epigenetics
Mechanisms of carcinogenesis
Medicinal chemistry/drug development
Oncogenic cell signaling
REDOX biology
Tumor microenvironment
Other
Cancer disparities
Cancer epidemiology
Cancer prevention & risk reduction
Cancer screening
Caregiver and behavioral intervention research
Environmental carcinogenesis
Health equity
Health services research
Implementation and dissemination science
Nutrition/obesity and cancer
Quality-based research
Rural healthcare
Tobacco cessation
Cancer immunotherapy
Cellular therapy
Coagulation and thrombosis/hemostasis in cancer patients
Early phase clinical trials
Experimental therapeutics
Integrative oncology
Survivorship/supportive care