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Membership Application

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Contact Information
Institution Information
Specialty (check all that apply)
Membership Category (select one)
Committee Selection
For the next question, please select at least one preference for which committee you would like to be actively involved in.  If there are more than one, you have the option of ranking them.
  
Data Committee: This group oversees the use of data by researchers in the Cholangiocarcinoma Foundation Patient Registry (CCF Registry—powered by Citizen Health), Komodo Health (a healthcare data analytics company), the Genome-Wide Association Study, and data available in cBioPortal. The group is also tasked with harmonizing the ICPR with other national/international datasets to develop greater strength in numbers. 
  
Research Committee: The Cholangiocarcinoma Foundation has an expanding grant-awarding program. This group oversees the annual Fellowship Grants, the expansion of the Innovation Grants, and the Career Development Awards. Members from this committee can also be selected to serve on the grants reviewer panel. They also monitor previously awarded grants, e.g., C2T2 (Cure Cholangiocarcinoma Think Tank), and any research collaborations with industry. A subgroup is tasked with delivering the Master Protocol in BTC.    
 
Next-Generation Committee: The next generation of clinicians, scientists, and investigators is key to the future success of improved outcomes for patients with cholangiocarcinoma. This group provides mentorship to early-career members through webinars, young investigator meetings, and international initiatives.   
 
Program Organizing Committee: The Foundation hosts an established Annual Conference, and this committee provides strategic direction and oversight for its planning and execution. Responsibilities include setting the conference theme, reviewing abstracts and posters, publishing meeting proceedings, and managing CME accreditation. Additionally, the committee collaborates with local hosts to oversee regional meetings (such as the Asia-Pacific Cholangiocarcinoma Conference) and supports the development of any new international conferences (e.g., in Africa). 
Please select a preference for which committee you would like to be actively involved in.  If there are more than one, you have the option of ranking them. 

Please rank (1-3) the following in order of interest:
All members will be informed of their committee allocation – every effort will be made to accommodate your first preference. 
Drag your choices here to rank them
    • Data Committee
      1
    • Research Committee
      2
    • Program Organizing Committee
      3
    • Next-Gen Committee
      4
    How did you learn about the ICRN? (select all that apply)
    Diversity, Equity, and Inclusion (DEI)
    Providing your race/ethnicity information helps the Cholangiocarcinoma Foundation promote inclusivity and ensure that our research and initiatives represent the diverse communities we serve. Your participation supports our commitment to equity in healthcare.

    What is your Race/Ethnicity? (optional)    Race Definitions
    Membership Requirements & Confidentiality Statement
    As a member of the International Cholangiocarcinoma Research Network (ICRN), you will have access to proprietary and confidential information related to ongoing research, clinical trials, and data from various resources, including the Cholangiocarcinoma Foundation Patient Registry, Komodo Health data, Genome-Wide Association Studies, and cBioPortal.

    To protect the integrity of this information and foster collaboration, all members of the ICRN are required to adhere to the following confidentiality terms:

    Confidential Information: Confidential information includes, but is not limited to, any unpublished research data, methodologies, results, analyses, protocols, financial details, or other proprietary information shared during ICRN meetings, projects, or communications. This includes information pertaining to grant programs, patient data registries, and collaborative initiatives with industry or academic institutions.

    Non-Disclosure and Use Limitation: As an ICRN member, you agree to use the confidential information solely for the advancement of cholangiocarcinoma research and patient care, as outlined by the network’s mission. You will not disclose any confidential information to third parties without prior written consent from the Cholangiocarcinoma Foundation (CCF) or the relevant Disclosing Party. Disclosure within your institution or to collaborators is permitted only if those individuals are bound by confidentiality obligations at least as stringent as those outlined in this statement.

    Exceptions to Confidentiality: The confidentiality obligations do not apply to information that:
    - Is publicly available at the time of disclosure;
    - Becomes publicly available through no fault of your own;
    - Was in your possession before receiving it through ICRN;
    - Is received from a third party without an obligation of confidentiality.

    Legal Disclosures: In the event you are legally required to disclose confidential information, you agree to notify CCF promptly and assist in seeking protective measures to limit the disclosure.

    Commitment to Confidentiality: By accepting ICRN membership, you acknowledge the importance of maintaining confidentiality to protect sensitive research, clinical trials, and patient data. This commitment fosters trust and ensures continued collaboration among global institutions dedicated to improving outcomes for patients with cholangiocarcinoma.
    Optional:  Activities that directly involve industry partners (e.g., Master Protocol, Industry Forums) will require an additional Confidential Disclosure Agreement (CDA) signed via DocuSign, which we will coordinate with you as appropriate. Participation is contingent on having a current CDA signed within the last three years. 

    Would you be interested in participating in these activities?
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