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Get Involved

As general evidence of my commitment, I agree to the following (check all that apply):
- Select All
- Actively participate in the Increasing HPV Vaccination Rates Task Force
- Actively participate in the Early Detection Health Equity Task Force
- Actively participate in the Patient Support & Quality of Care Task Force
- Serve on a cross-cutting committee
- Serve as an activity lead for a task force action plan strategy that aligns with my organization’s goals
- Serve in a Coalition leadership capacity
- Steering Committee Member (application required)
- Read minutes, reports and newsletters to keep abreast of coalition decisions/activities
- Disseminate relevant information and coalition funding opportunities as appropriate
- Keep the coalition informed of my related activities
Specifically, I and/or my organization will commit the following resources to the coalition (check all that apply)
- Select All
- Staff hours
- Educational materials
- Access to our staff or volunteers for coalition tasks or events
- Access to our organization's facilities for Coalition events
- Procurement of items/services/other financial resources
- Connections to other key organizations/individuals
- Sponsorship for Coalition event(s)
- Other, please specify
Other, please specify
Name
First Last
Organization
Title
Email Address
Signature
Date
MM slash DD slash YYYY
I am committed to be an active member of the SD Cancer Coalition. I am committed to the vision and mission of the coalition and the goals of the SD Cancer Plan 2021-2025. I am committed to the planning, collaboration, implementation, and evaluation process of the coalition. I acknowledge the contributions and expectations of the other members of the Coalition.
I am committed to be an active member of the SD Cancer Coalition. I am committed to the vision and mission of the coalition and the goals of the SD Cancer Plan 2021-2025. I am committed to the planning, collaboration, implementation, and evaluation process of the coalition. I acknowledge the contributions and expectations of the other members of the Coalition.
- Yes, I agree to the above statement

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