Register Your NCSD Event

Organize an Event – A Planning Guide
Register Your Event

Please register your 2012 event with the NCSD Foundation so that you can use the copyrighted NCSD name and logo (each year’s event must be registered separately). Fill out and submit the registration form below.

There is no cost to register, and doing so has many benefits: You will be eligible to order official NCSD merchandise, you will receive special offers extended only to registered organizations, and the NCSD newsletter will automatically be sent to you.

Once you have registered your event, you will have access to exclusive online resources, including a searchable Speakers Bureau Roster and digital logos. You will also be able to order free Welcome Brochures, free Cancer Survivor Resource Guides, and free copies of Coping® magazine’s May/June issue to distribute at your event. The order form for free materials is at the bottom of the Registration form.

NCSD 2012 EVENT REGISTRATION FORM

Event Contact Information

First Name:* First name is required.

Last Name:* Last name is required.

Anticipated Event Date:
format yyyy/mm/dd* A value is required.
Date format must be yyyy/mm/dd, such as 2012/06/03.

Sponsoring Organization:*

Email:* An email address is required.Invalid format.

This address is Residential Business

Address:* A value is required.

City:* A value is required.

State:* A value is required.

Zip/Postal Code:* A value is required.

Country:* A value is required.

Phone Number:* A phone number is required.

Fax Number:

Tell us about your event

Event Name:* An event name is required.

Event Description:

Expected Attendance: Invalid format.

Other organizations working with you:

Scheduled Speakers:

Do you want your event publicized?
Yes, please publicize No, do not publicize

Order Free Materials for Your Event (US locations only) - Deadline: March 30, 2012

NCSD “Welcome” Brochures

This brochure includes a “welcome” from the National Cancer Survivors Day Foundation, messages from prominent national officials, background on NCSD and facts on cancer and cancer survivorship issues. Shipped in May. Limited quantities.

Quantity Requested: Invalid format.

Cancer Survivors Resource Guide

This guide lists America’s leading cancer information and support services as furnished by Coping® magazine. Shipped in May. Limited quantities.

Quantity Requested: Invalid format.

If shipping address is not the same as the above address, enter shipping address.

This address is Residential Business

Ship to Name:

Ship to Organization:

Ship to address (not PO box):

Ship to City:

Ship to State:

Ship to Zip Code:

Coping® Magazine - download order form at ncsd.org

Give Coping, the gift of knowledge, hope and inspiration, to those attending your local NCSD event. Copies of the May/June 2012 issue of Coping With Cancer, the magazine for people whose lives have been touched by cancer™, will be available while supplies last. All Coping asks is that you pay freight and handling. Coping is an NCSD National Sponsor.

* This box must be checked to submit your National Cancer Survivors Day event. By checking this box, you state that you and your sponsoring organization/s agree to the terms and conditions set forth in Registration & Authorization.