2010 Membership Application

Please complete this form exactly as you want it to appear in the CRANE roster. 

Annual membership dues are $15.00.  Membership runs from January 1 to December 31.  There is a late fee of $2.50 if dues are not paid on or before April 15th.  Unpaid dues will result in forfeiture of membership and a reinstatement fee of $5.00 will be required.  This has been approved by the Executive Committee and will be enforced. 

Active Member - An active member shall be a Certified Tumor Registrar and/or any person whose primary occupation is involved with any or all facets of Tumor Registry work and who is employed and/or resides within the six state New England region.  An active member shall be entitled to all membership privileges including the right to vote, hold office or chair a committee.

Associate Member - An associate member shall be any person interested in the purpose of CRANE.  An associate member shall not hold office, shall not vote, or chair a committee but may be appointed to serve on a committee.

Existing members - Email us if your contact information changes.  It is essential for you to notify the Membership Chairperson. 

*required information

*Membership Type
*First Name
MI
*Last Name
Credentials
Company
*Preferred Address
Address
*City
*State
*Zip
*Phone Number
*Email
Opt-Out

Do not include my membership information in the CRANE roster.

Payment options include: Credit card and check

 * Email us if your contact information changes.  It is essential for you to notify the Membership Chairperson.