Metastatic Breast Cancer Alliance - Membership Application: Individual
RequiredRequired Question(s)
Welcome! Thank you for your interest in becoming involved with the MBC Alliance.

Our Vision
Transform and improve the lives of people living with metastatic breast cancer.

Our Mission
Unify the efforts of MBC Alliance members to improve the lives of, and outcomes for, those living with metastatic breast cancer and their families through increasing awareness and education about the disease and advancing policy and strategic coordination of research funding specifically focused on metastasis that has the potential to extend life, enhance quality of life and ultimately to cure.

Our Goals
Work together towards a time when: 
- All MBC patients and their caregivers can access the care and services they need from a responsive and well-informed healthcare system
- MBC stakeholders - including those diagnosed and their families, health care providers, researchers, health policy influencers and policy makers - understand MBC and how it differs from early stage breast cancer
- MBC research focuses on extending life, enhancing quality of life and ultimately ending death from the disease
 
Individual Membership Description:
 
Individuals (either patients or independent patient advocates) committed to the mission and vision of the Alliance and to pro-actively planning and executing initiatives including contributing necessary time and talent resources have the opportunity to join the Alliance. 

Individuals are NOT required to make a financial commitment of any kind to join the Alliance. 

Activities of the Alliance that require funding are supported by the unrestricted financial contributions of the pharmaceutical and biotech members.


 
Responsibilities include:

1. Understanding and supporting the mission and objectives of the MBC Alliance as described in the Landscape Analysis published by the Alliance in 2014 

2. Staying current on patient concerns, issues, and interests as they relate to metastatic breast cancer

3. Responding, after reflection and discussion among the other individual members, with a unified patient perspective to Alliance initiatives

4. Submitting new ideas or initiatives to the Alliance leadership team for consideration. Such ideas or initiatives should further the mission and objectives of the Alliance

5. Offering recommendations which will enhance Alliance written or website communications to both the metastatic breast cancer community and the public 

6. Acting as Alliance Patient Ambassadors to promote the mission and initiatives of the Alliance to MBC patient advocate groups and MBC individuals via individual social media channels or blogs

7. Attending virtual meetings approximately once every six weeks 

 
Membership applications are reviewed based on:
1. Demonstrated pro-active interest/expertise in patient advocacy work
2. Professional/personal skills that can be leveraged by the MBC Alliance to support the Metastatic Breast Cancer Community
3. Ability and commitment to support the MBC Alliance's mission and objectives

 
Required

I am are applying for membership as: 

An MBC Patient
An Independent Patient Advocate
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Tell us about you...


First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

Facebook Page

 

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Twitter Handle

 

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Blog URL
 

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Website

 

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Briefly describe why you are interested in becoming a member of the Alliance.

 

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Write a short statement regarding your advocacy work or experience in the areas of advancing research, information and support services, awareness and education, and/or policy regarding metastatic breast cancer.

 

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What specific advocacy training (e.g., Project LEAD, LBBC's "Hear My Voice") have you had? 

 

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What other advocacy organizations or individual patient advocates do you currently work with or have you worked with in the past?

 

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Outline the ways you can contribute to the MBC Alliance, e.g., volunteering your time to promote the Alliance's initiatives as well as MBC-specific initiatives of other MBCA members.

 

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In which area(s) are you able to collaborate to meet the goals of the Alliance? Check all that apply.

Furthering research
Improving quality of and access to information and support
Shaping policy
Building awareness of the Alliance's strategic initiatives as well as of MBC in general
Other  
  • Comment:

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In submitting this application, I understand that, as an active member of the MBC Alliance, I
(i) commit to working collaboratively and cooperatively with other Alliance members;
(ii) will help to promote the work of the Alliance and its member via social media and other networks;
(iii) will contribute my time to advancing the efforts of the Alliance; and
(iv) will NOT misrepresent or disparage the Alliance, its members or its activities in any way.

 
Required

Initial here to acknowledge that you have read and understand the above.

 

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