2023 Elevate Ambassador Application - NCCS - National Coalition for Cancer Survivorship

2023 Elevate Ambassador Criteria and Application

Improving Cancer Survivorship Care Begins In Your Backyard

Elevate Ambassadors are advocates and survivorship professionals who work to improve survivorship care in their communities. Ambassadors receive mentorship, support, networking opportunities, and in-person training to develop and execute a plan-of-action for their project to serve their local or virtual community.

It may seem like no small task for Elevate Ambassadors to make a difference in cancer care in their communities — that’s because it isn’t. Yet, it’s an incredible opportunity to receive the training and mentorship to make a real difference for survivors and their loved ones who are neighbors, colleagues, friends, and more.

2023 Elevate Ambassador Application Deadline: June 16, 2023 at 11:59 PM ET.

A sample of 2022 Elevate Ambassador projects:

Art of Awareness Campaign to elevate voices of Oral Head and Neck Cancer survivors
Doctoral dissertation on health literacy evaluation of resources provided on NCI designated Cancer Centers’ websites
Faith-based outreach program for a survivorship clinic in Camden, New Jersey
Patient Advocacy Curriculum for those diagnosed with breast cancer in Flint, Michigan
Survivorship Provider Toolkit for a Cancer Center in Memphis, Tennessee

2023 Ambassador Program

NCCS’s State of Cancer Survivorship Survey: 2022 revealed disparities in cancer care by race, ethnicity, socioeconomic status, geography, education, and age at the time of their diagnosis. These disparities result in disproportionately negative impacts on survivors’ careers, finances, and overall health.

NCCS believes collaborating with advocates and survivorship professionals on a local level is a critical step toward addressing inequity. We welcome advocates and survivorship professionals who are passionate about improving survivorship in their community to apply to the 2023 Elevating Survivorship Ambassador Program. While we encourage all to apply, we are especially interested in projects that address health inequities. Ambassadors will receive support, mentorship, and training throughout the two-year program to successfully direct their project.

Criteria

An Ambassador must be:

An advocate or survivorship professional (researcher, health care provider, or survivorship program manager), age 18 or older, who has been touched by cancer.
Committed to working at the local level to improve survivorship.
A resident of the United States of America.

Preferred Expertise & Composition. Ideal Ambassadors have general knowledge of survivorship, have developed relationships in the cancer community, and have the public speaking skills needed to be a part of presentations and trainings in virtual and in-person settings.

Program and Time Commitment

Ambassadors will implement a specific project, including completing a needs assessment, developing goals, creating a project plan and timeline, and implementing the plan.
Virtual kick-off meeting on August 2, 2023 at 4:00 pm ET
Attendance at an in-person training* in Washington, DC on August 24 and 25, 2023. Travel and lodging for Ambassadors will be paid for by NCCS.
Learning collaborative calls/webinars with educational topics on the following Wednesdays at 4:00 pm ET:
- September 13, 2013
- November 15, 2023
- January 24, 2024
- March 13, 2024
- May 15, 2024
Mentorship and support by NCCS team.
Report progress on project plan goals and action items.
Ambassadors will be encouraged to identify a “sponsor/partner/mentor” who will be a point-of-contact for them in their community and work collaboratively with them. This partnership will become a source of accountability and guide the process of sharing their project with the community.

*Subject to change

Application Form

Applications must be submitted by June 16, 2023 at 11:59 PM ET.

Save and Continue Feature
If you need more time to complete your application, click the “Save Progress and Continue Later” link at the bottom of the form next to the “Submit” button. A secure link, valid for up to 30 days, will be emailed to you. Note: Only text fields will be saved. Uploaded documents will NOT be saved when continuing the form from the secure link. You must re-upload the documents prior to final submission.

If you have any questions or need assistance with the form, please contact us at elevate@canceradvocacy.org
Name*
Prefix First Last Credentials (if applicable)
Preferred Pronouns (Optional)

Examples: she/her/hers, he/him/his, they/them/theirs, etc...
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Enter Email Confirm Email
Phone*
Date of Birth*
Are you a Cancer Survivor and/or a Caregiver?*
- Cancer Survivor
- Caregiver
- Not Applicable
Are you a Health Care Provider and/or Nonprofit Professional?*
- Health Care Provider
- Nonprofit Professional
- Not Applicable
Organization and/or Specialty

If you're not affiliated with an organization, type "N/A"
Race/Ethnicity (Optional)
Select all that apply.
- American Indian or Alaska Native
- Asian or Asian American
- Black or African American
- Hispanic or Latin American
- Middle Eastern or North African
- Native Hawaiian or Other Pacific Islander
- White or Caucasian
- I prefer not to answer.
Employer (Optional)
Title (Optional)
Expertise and Interests
Describe why you would like to become an Elevate Ambassador and represent NCCS.*
What are the specific survivorship needs in your local or virtual community?*
Please describe a specific project idea and how it will address the survivorship needs in your community that you shared above.*
Please share how your personal and professional cancer advocacy experiences will support you in developing and implementing your project.*
(e.g. volunteering at a survivorship clinic, advocacy groups, etc.)
Please describe your current relationships in the cancer community and how you will continue to foster relationships with relevant stakeholders to support your project.*
OPTIONAL: Add links to online content, including articles or videos of your public speaking.
Click the "Plus" symbol to add more than one link.
Description Link
In-Person Training Attendance*
- I can attend the in-person Elevate Ambassador training in Washington, DC on August 24 and 25, 2023.
Do you understand the time that may be required to be an Ambassador?*
- Yes
- No
Upload a narrative biography, resume, and/or CV.*
Drop files here or

Accepted file types: doc, docx, pdf, odt, fodt, Max. file size: 5 MB, Max. files: 3.
(MS Word, PDF, or OpenOffice formats accepted.)
Upload a letter of support.*
Attach a letter of support from an individual or organization. The letter should address your ability to serve as an Elevate Ambassador and your interest in cancer advocacy and survivorship care.

(MS Word, PDF, or OpenOffice formats accepted.)
Accepted file types: doc, docx, pdf, rtf, odt, fodt, Max. file size: 5 MB.
Certification*
- I certify that the information I've provided in this application is accurate.
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.

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