Consortium Membership Application

If you do not already have an ORCID, please register for one at https://orcid.org/

Primary Institution*

For example: Professor

For example: Physician

This may be in addition to or separate from your research appointment

Fred Hutch Research Division

For example: Principal Investigator

For example: Physician

This may be in addition to or separate from your research appointment

Seattle Children's Research Center

For example: Professor

For example: Physician

This may be in addition to or separate from your research appointment

UW School/College

Select all that apply.

Will you be conducting interventional cancer-related trials with human subjects in the next 12 months?*
Are you a member of the Institute of Translational Health Sciences (ITHS)?*

Select the Consortium Program to which you are applying:*

Provide examples of research grants, publications, clinical studies, etc.

Select all that apply.


All publications, press releases, or other documents that cite results from CCSG-supported research (including if resulting from the use of one or more Shared Resources) must include acknowledgement of the CCSG and maintain compliance with NIH Public Access Policy.


Recommended language:

  • This research was funded in part through the NIH/NCI Cancer Center Support Grant P30 CA015704.
  • This research was supported by the [insert name] Shared Resource of the Fred Hutch/University of Washington/Seattle Children's Cancer Consortium (P30 CA015704).

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