Become a Cancer Champion - Organisational Sign up

Organisation Name*

Alternative name(s)

Address

Street Address

Town/City

City

Postcode

ZIP / Postal Code

Email Address*

Phone number

Website

Twitter

Facebook

Instagram

Other

Number of Cancer Champions involved through your organisation (estimated)

Number of people your organisation is in contact with your mailing list/membership (estimated)

Where in Greater Manchester does your organisation work? (Please tick as many as you wish)

Which of the following groups does your organisation work with? (Please tick as many as you wish)

Specify other groups you work with

Please tell us briefly about your organisation (For example, what type of organisation are you and what do you do?)

First name*

First

Last name*

Last

Job title

Email address*

Phone number*

Consent*

I consent to Voluntary Sector North West processing my data in accordance with my role as a Cancer Champion and sharing my data with members of the Answer Cancer partnership. My data will not be shared with any other third party with my prior additional consent being obtained. The personal details I have provided will only be used for communication around Cancer Champion activities, I give you permission to contact me by email or telephone for these purposes only.

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To find out more about what it means to be an Organisational Cancer Champion visit here.