Membership Application Form

Membership Application

  • General Information

    If membership is approved, this information will be used to populate your investigator profile for the Hillman Research website and Research Logix database.
  • Date Format: MM slash DD slash YYYY
  • Your ID number can be found on your University ID or under Employment Info in PittWorx.

  • Research

  • Please describe your current cancer-related research, the reason you are seeking membership, and how you envision your role at UPMC Hillman Cancer Center:

  • Research Areas for Membership

  • You may select up to two research areas, in order of importance, that best match your scientific interests and in which you would like to participate as a Hillman member. Please note, however, that membership will be awarded in only one program.

  • Programs

  • Shared Resources

  • Shared Resources are listed below. Please indicate those you are currently using and any that you might use in the future.

  • Please provide electronic copies of the following documents at the time of submitting your application:

  • Including publications
  • Please provide a list of active and pending grant support (research and training).

  • Please note: Before your application can be approved, you are required to meet with a research program co-leader from the primary area of research selected above and present at an upcoming Research Advisory Counsel (REAC) meeting. Our membership coordinator will reach out to you to schedule your REAC presentation. Questions regarding the process can be directed to HCCMembership@upmc.edu.