Registration for The Science of Cancer Online Course – Canadian Cancer Survivor Network

Thank you for your interest in CCSN's The Science of Cancer online course. Please fill out the registration form below and we will get back to you within a couple of days with further instructions on how to access the course.

Name*
This is the name that will show up on your certificate of completion.
First Last
Email*
Password*
Enter Password Confirm Password
Address*
This course is intended for Canadian residents only.

Street Address Address Line 2 City Province Postal Code
Why are you interested in taking this course?
Do you have a personal connection to cancer?
- I have cancer
- I am a cancer survivor
- I am/was a family member of a cancer patient
- I am/was a caregiver for a cancer patient
- I am a professional who works with people impacted by cancer
Age*
What is your highest level of education?*
It is highly recommended that you have completed high school before taking this course.
Which best describes your current employment status?
How would you describe your profession?
Please list any current or past involvement that you have had with organizations focusing on improving the lives of those affected by cancer.
Do you identify as having a visual or mobile disability which causes difficulty and/or frustrations when using online technology?
Unfortunately the course is not accessible at this time but we will do our best to accommodate those with a disability.
- Yes
- No
Would you like to be added to CCSN's mailing list to stay informed on news and events of interest to the cancer community?*
- Yes
- No
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