Join ANZUP

ANZUP Membership benefits include:

• Access to a professional network for Urologenital and Prostate cancer research, including clinicians, nursing staff, industry affiliates and patient / consumer representatives
• Support for the development of investigator-initiated studies
• Access to educational workshops and seminars
• Access to grant opportunities
• ANZUP quarterly newsletter and the latest sector news updates
• Voting rights at ANZUP annual general meeting and at other general meetings at ANZUP
• Opportunity to contribute to ANZUP's subcommittees
• Other benefits that will be extended from time to time for members only

Title:	Ms Mrs Mr Dr A/Prof Prof
First Name *:
Last Name *:
Profession Category:	Clinical Trials Coordinator Endocrinologist Epidemiologist General Practitioner Medical Oncologist Pathologist Psychologist Radiation Oncologist Registered Nurse Scientist Statistician Urologist Other, please specify
If other, please specify:
Institution:
Address:
Suburb:
State *:
Postcode *:
Country *:	Australia New Zealand Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic of the Cook Islands Costa Rica Cote D'ivoire Croatia (Local Name: Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and Mc Donald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, The Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova, Republic of Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory, Occupied Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Province of China Tajikistan Tanzania, United Republic of Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe
Do you live in a rural / remote area? *:	Yes No
Email *:
Phone:
Mobile:
Facsimile:
Diseases Interested in:
Do you wish to join one or more of the subcommittees of the Scientific Advisory Committee?	Bladder Germ cell Prostate Renal Correlative and Translational Research Quality of Life & Supportive Care Consumer Advisory Panel
Proposed By *:	Prof Ehtesham Abdi Prof Stephen Ackland Dr Gias Ahmed Mr Paul Anderson Dr Peter Aslan Dr Stephen Assinder Dr Lyn Austen Dr George Au-Yeung Dr Nader Awad Dr Arun Azad A/Prof Peter Baade Dr Selvamani Backianathan Dr Sanjeev Bandi Dr Genevieve Baratiny Dr John Barlow Dr Patricia Bastick Mrs Kate Battersby A/Prof Judy Bauer Dr Siddhartha Baxi Dr Stephen Begbie Dr Melanie Bell Douglas Bellamy A/Prof Martin Berry Ms Jody Berry Mr Gregory Bock Ms Amy Boland A/Prof Damien Bolton Dr Ben Britton A/Prof Nicholas Brook Mr Andrew Brooks Dr Reuben Broom Dr Stephen Brown Mr Nicholas Buchan Mrs Kiran Buckley Ms Petrina Burnett Dr Lisa Butler Prof Phyllis Butow Ms Alison Byrne Dr Alistair Cameron-strange Mr Matthew Carr Mrs Christine Carrington Prof Gregory Carter Ms Tina Cavicchiolo Dr Venu Chalasani Prof Suzanne Chambers Dr Sarat Chander Dr Joe Chang Dr Christophe Chemasle Dr Colin Chen Dr Ada Cheung A/Prof Pauline Chiarelli Dr Michael Chong Dr Peter Chong Dr Sam Chopra A/Prof David Christie Dr Amanda Chung Dr Marika Ciprotti Prof Judith Clements Dr David Clouston Ms Angela Cotroneo Mr Keith Cox A/Prof Paul Craft Dr Michelle Cronk Ms Annette Cubitt Dr Katharine Cuff Dr Robert Davies Prof Ian Davis Prof Paul de Souza Prof Warick Delprado Prof James Denham Mrs Rhonda Devine Dr Haryana Dhillon Prof Cristobal dos Remedios Ms Pam Doughty Dr Anthony Dowling Dr Divyanshu Dua Prof Gillian Duchesne Dr Patrick Dwyer Ms Monika Dzidowska Dr Thomas Eade Dr Renu Eapen Dr Jim Edwards Mr Peter Elgin Dr David Ende Prof Richard Epstein Dr Stephen Esler Mr Giuseppe ( Joe) Esposito Ms Megan Ferguson Dr Richard Ferguson Ms Merran Findlay Dr Peter Chee Choong Fong Dr Garry Forgeson Mr Trevor France A/Prof Mark Frydenberg Dr Hui Gan Ms Soula Ganiatsas Dr Vinod Ganju Prof Robert "Frank" Gardiner Ms Chantal Gebbie Dr Craig Gedye Dr Troy Gianduzzo Dr Jemma Gilchrist Dr Sanjeev Gill A/Prof Peter Gilling Prof Afaf Girgis Dr Jeffrey Goh Mr Albert Goikhman Prof David Goldstein Mr Jay Griffiths Dr David Grimes Dr Peter Grimison Mr Jeremy Grummet A/Prof Alexander Guminski A/Prof Howard Gurney Mr Dennis Gyomber Prof Marion Haas Ms Kathy Hall Mr Akhlil Hamid Dr Emma Hamilton Dr Kate Hamilton Dr Fritha Hanning Dr Aaron Hansen Mr Chris Hansen Ms Lynda Hardy A/Prof Maryanne Hargrave Mr Matthew Harper Dr Carole Harris Dr Michelle Harrison Dr Amy Hayden Prof Dickon Hayne Ms Jodie Head Dr Peter Heathcote Dr Olivia Herdiman Dr Ben Hindson Mr Chris Hodgkins Dr Lisa Horvath Dr Baerin Houghton A/Prof Christopher Hovens Dr Elizabeth Hovey Mr Nicholas Howard Dr George Hruby Dr Anthony Hutton Dr Joseph Ischia Dr Michael Izard Dr Gregory Jack Mrs Belinda Jago Mrs Kathryn Jenkins Dr Anthony Joshua Prof George Kannourakis Dr Narayan Karanth Mr Paul Katris Dr Darren Katz Prof Dorothy Keefe Dr Liz Kenny A/Prof Justin Keogh Prof Mohamed Khadra Mrs Sally Kidd Dr Belinda Kiely Ms Heather Kilsby Prof Madeleine King Mr Quinten King Dr Andrew Kneebone Dr Jennifer Kong Dr Raji Kooner Ms Tina Kopsaftis A/Prof Dusan Kotasek A/Prof Mei Krishnasamy Dr Melvyn Kuan Dr Jimmy Lam Dr Sylvie Lambert Mr Craig Lancaster Dr Sze Ting Lee Dr Jeremy Lewin Dr Sem Liew Dr Daryl Lim Joon Dr Peter Loa Dr Mark Louie-Johnsun Dr Mikhail Lozinskiy Dr Tim Luckett Dr William Lynch Mr Finlay Macneil Dr Kate Mahon A/Prof Paul Mainwaring Dr David Malouf Mr Rustom Manecksha Mr Andrew Martin Ms Linda Martin Dr David John Martin Dr Jarad Martin A/Prof Gavin Marx Dr Elizabeth Jane McCaffrey Mrs Sally McCowatt Mr Rob McDowall Mr John McIlrath Mrs Lauren McIlrath Ms Margaret McJannett A/Prof Joe McKendrick Mrs Sandy McKiernan Ms Jessica Medd Mr Danny Merhi A/Prof Jeremy Millar Prof John Mills Dr Gillian Mitchell Dr Katerina Mitsakos Prof Leanne Monterosso Mrs Janet Moore Dr Melissa Moore Dr Kim Moretti Mrs Aruna Morris A/Prof Declan Murphy Ms Kathryn Nattress Mrs Jillene Naylor Mr Mischel Neill Dr Siobhan Ng Mr Quoc Nguyen Dr Louise Nott Mr Colin O'Brien Dr Stefano Occhipinti Prof Ian Olver Dr Wei Ling Ooi Dr Zulfiquer Otty Dr Phillip Parente Ms Rhonda Partridge Dr Nitya Patanjali Dr Manish Patel A/Prof Sanjoy Paul Dr Nick Pavlakis Ms Alison Pearce Dr Adam Pearce Dr Maria Pearse Dr Michelle Peate A/Prof David John Perez A/Prof Janette Perz Dr Carmel Pezaro Mr Nick Ploumatos Dr Morgan Pokorny Dr David Pook Dr Ganes Pranavan Mr Steve Pratt Dr Melanie Price A/Prof David Quinn Dr Weranja Ranasinghe Dr Frank Redwig Mr Barry Rendell Mrs Karen Rendell Ms Alison Richards Dr Rahul Rindani Prof Gail Risbridger Prof Mark Rosenthal Prof Pamela Russell Dr Steve Ruthven Dr Andrew Ryan Ms Lesley Anne Ryan Dr Nikhil Sapre Dr Prassannah Satasivam Dr Manvendra Saxena Ms Barbara Scher Dr Joseph Schoeman Ms Kath Schubach Prof Andrew Scott Dr Sid Selva-Nayagam Mr Shomik Sengupta Dr Kapil Sethi A/Prof Gianluca Severi Dr Sanjeev Sewak Dr Bhaumikkumar Shah Dr Tom Shannon A/Prof Jeremy Shapiro Prof Christopher Sharpley Dr Serena Sia Dr Sheryl Sim Dr Shankar Siva Dr Katrin Sjoquist Dr Marketa Skala Dr Pavel Sluka Mr Allan "Ben" Smith Mrs Jo Smith Dr Ian Smith Mrs Helen Smith A/Prof Raymond Snyder Dr David Sofield Mr Anthony (Tony) Sonneveld Dr Daniel Spernat Prof Nigel Spry Dr Christopher Steer Dr Amanda Stevanovic Mr Ben Stevenson Dr Josephine Stewart A/Prof Martin Stockler Ms Caroline Stone Mr John Stubbs Mr Rodney Studd Dr Paul Sved Dr Peter Swindle Dr Alireza Tafreshi Dr Keen-Hun Tai Mrs Kay Talbot Mr Edwin Tan Dr Philip Tan Dr Thean Hsiang Tan Dr Andrew Tan Dr Colin Tang Dr Renea Taylor Mrs Jennifer Thompson A/Prof Damien Thomson A/Prof Guy Toner Ms Patricia Townsend Dr Ben Tran Dr Yen Tran Dr Simon Troon Mr Andrew Troy Dr Sandra Turner Dr Craig Underhill Prof Jane Ussher A/Prof Celi Varol Dr Ian Vela Ms Vicki Velonas A/Prof Rosalie Viney Mr Justin Vivian Dr Mark Voskoboynik Mr Michael Wallace A/Prof Euan Walpole Ms Wendy Watts Mr Sydney Weinstein Dr David Wetherell Prof Kate White A/Prof Scott Williams Dr (Andy) Chuk Moon Won Dr Lih-Ming Wong Dr Tim Wong A/Prof Henry Woo Dr Addie Wootten Dr Miranda Xhilaga Prof Patsy Yates Dr Trina Yeadon A/Prof Desmond Yip Dr Sonia Yip Dr Chew - Lin Yip Dr Nikolajs Zeps Dr Rachel Zordan
Seconded By *:	Prof Ehtesham Abdi Prof Stephen Ackland Dr Gias Ahmed Mr Paul Anderson Dr Peter Aslan Dr Stephen Assinder Dr Lyn Austen Dr George Au-Yeung Dr Nader Awad Dr Arun Azad A/Prof Peter Baade Dr Selvamani Backianathan Dr Sanjeev Bandi Dr Genevieve Baratiny Dr John Barlow Dr Patricia Bastick Mrs Kate Battersby A/Prof Judy Bauer Dr Siddhartha Baxi Dr Stephen Begbie Dr Melanie Bell Douglas Bellamy A/Prof Martin Berry Ms Jody Berry Mr Gregory Bock Ms Amy Boland A/Prof Damien Bolton Dr Ben Britton A/Prof Nicholas Brook Mr Andrew Brooks Dr Reuben Broom Dr Stephen Brown Mr Nicholas Buchan Mrs Kiran Buckley Ms Petrina Burnett Dr Lisa Butler Prof Phyllis Butow Ms Alison Byrne Dr Alistair Cameron-strange Mr Matthew Carr Mrs Christine Carrington Prof Gregory Carter Ms Tina Cavicchiolo Dr Venu Chalasani Prof Suzanne Chambers Dr Sarat Chander Dr Joe Chang Dr Christophe Chemasle Dr Colin Chen Dr Ada Cheung A/Prof Pauline Chiarelli Dr Michael Chong Dr Peter Chong Dr Sam Chopra A/Prof David Christie Dr Amanda Chung Dr Marika Ciprotti Prof Judith Clements Dr David Clouston Ms Angela Cotroneo Mr Keith Cox A/Prof Paul Craft Dr Michelle Cronk Ms Annette Cubitt Dr Katharine Cuff Dr Robert Davies Prof Ian Davis Prof Paul de Souza Prof Warick Delprado Prof James Denham Mrs Rhonda Devine Dr Haryana Dhillon Prof Cristobal dos Remedios Ms Pam Doughty Dr Anthony Dowling Dr Divyanshu Dua Prof Gillian Duchesne Dr Patrick Dwyer Ms Monika Dzidowska Dr Thomas Eade Dr Renu Eapen Dr Jim Edwards Mr Peter Elgin Dr David Ende Prof Richard Epstein Dr Stephen Esler Mr Giuseppe ( Joe) Esposito Ms Megan Ferguson Dr Richard Ferguson Ms Merran Findlay Dr Peter Chee Choong Fong Dr Garry Forgeson Mr Trevor France A/Prof Mark Frydenberg Dr Hui Gan Ms Soula Ganiatsas Dr Vinod Ganju Prof Robert "Frank" Gardiner Ms Chantal Gebbie Dr Craig Gedye Dr Troy Gianduzzo Dr Jemma Gilchrist Dr Sanjeev Gill A/Prof Peter Gilling Prof Afaf Girgis Dr Jeffrey Goh Mr Albert Goikhman Prof David Goldstein Mr Jay Griffiths Dr David Grimes Dr Peter Grimison Mr Jeremy Grummet A/Prof Alexander Guminski A/Prof Howard Gurney Mr Dennis Gyomber Prof Marion Haas Ms Kathy Hall Mr Akhlil Hamid Dr Emma Hamilton Dr Kate Hamilton Dr Fritha Hanning Dr Aaron Hansen Mr Chris Hansen Ms Lynda Hardy A/Prof Maryanne Hargrave Mr Matthew Harper Dr Carole Harris Dr Michelle Harrison Dr Amy Hayden Prof Dickon Hayne Ms Jodie Head Dr Peter Heathcote Dr Olivia Herdiman Dr Ben Hindson Mr Chris Hodgkins Dr Lisa Horvath Dr Baerin Houghton A/Prof Christopher Hovens Dr Elizabeth Hovey Mr Nicholas Howard Dr George Hruby Dr Anthony Hutton Dr Joseph Ischia Dr Michael Izard Dr Gregory Jack Mrs Belinda Jago Mrs Kathryn Jenkins Dr Anthony Joshua Prof George Kannourakis Dr Narayan Karanth Mr Paul Katris Dr Darren Katz Prof Dorothy Keefe Dr Liz Kenny A/Prof Justin Keogh Prof Mohamed Khadra Mrs Sally Kidd Dr Belinda Kiely Ms Heather Kilsby Prof Madeleine King Mr Quinten King Dr Andrew Kneebone Dr Jennifer Kong Dr Raji Kooner Ms Tina Kopsaftis A/Prof Dusan Kotasek A/Prof Mei Krishnasamy Dr Melvyn Kuan Dr Jimmy Lam Dr Sylvie Lambert Mr Craig Lancaster Dr Sze Ting Lee Dr Jeremy Lewin Dr Sem Liew Dr Daryl Lim Joon Dr Peter Loa Dr Mark Louie-Johnsun Dr Mikhail Lozinskiy Dr Tim Luckett Dr William Lynch Mr Finlay Macneil Dr Kate Mahon A/Prof Paul Mainwaring Dr David Malouf Mr Rustom Manecksha Mr Andrew Martin Ms Linda Martin Dr David John Martin Dr Jarad Martin A/Prof Gavin Marx Dr Elizabeth Jane McCaffrey Mrs Sally McCowatt Mr Rob McDowall Mr John McIlrath Mrs Lauren McIlrath Ms Margaret McJannett A/Prof Joe McKendrick Mrs Sandy McKiernan Ms Jessica Medd Mr Danny Merhi A/Prof Jeremy Millar Prof John Mills Dr Gillian Mitchell Dr Katerina Mitsakos Prof Leanne Monterosso Mrs Janet Moore Dr Melissa Moore Dr Kim Moretti Mrs Aruna Morris A/Prof Declan Murphy Ms Kathryn Nattress Mrs Jillene Naylor Mr Mischel Neill Dr Siobhan Ng Mr Quoc Nguyen Dr Louise Nott Mr Colin O'Brien Dr Stefano Occhipinti Prof Ian Olver Dr Wei Ling Ooi Dr Zulfiquer Otty Dr Phillip Parente Ms Rhonda Partridge Dr Nitya Patanjali Dr Manish Patel A/Prof Sanjoy Paul Dr Nick Pavlakis Ms Alison Pearce Dr Adam Pearce Dr Maria Pearse Dr Michelle Peate A/Prof David John Perez A/Prof Janette Perz Dr Carmel Pezaro Mr Nick Ploumatos Dr Morgan Pokorny Dr David Pook Dr Ganes Pranavan Mr Steve Pratt Dr Melanie Price A/Prof David Quinn Dr Weranja Ranasinghe Dr Frank Redwig Mr Barry Rendell Mrs Karen Rendell Ms Alison Richards Dr Rahul Rindani Prof Gail Risbridger Prof Mark Rosenthal Prof Pamela Russell Dr Steve Ruthven Dr Andrew Ryan Ms Lesley Anne Ryan Dr Nikhil Sapre Dr Prassannah Satasivam Dr Manvendra Saxena Ms Barbara Scher Dr Joseph Schoeman Ms Kath Schubach Prof Andrew Scott Dr Sid Selva-Nayagam Mr Shomik Sengupta Dr Kapil Sethi A/Prof Gianluca Severi Dr Sanjeev Sewak Dr Bhaumikkumar Shah Dr Tom Shannon A/Prof Jeremy Shapiro Prof Christopher Sharpley Dr Serena Sia Dr Sheryl Sim Dr Shankar Siva Dr Katrin Sjoquist Dr Marketa Skala Dr Pavel Sluka Mr Allan "Ben" Smith Mrs Jo Smith Dr Ian Smith Mrs Helen Smith A/Prof Raymond Snyder Dr David Sofield Mr Anthony (Tony) Sonneveld Dr Daniel Spernat Prof Nigel Spry Dr Christopher Steer Dr Amanda Stevanovic Mr Ben Stevenson Dr Josephine Stewart A/Prof Martin Stockler Ms Caroline Stone Mr John Stubbs Mr Rodney Studd Dr Paul Sved Dr Peter Swindle Dr Alireza Tafreshi Dr Keen-Hun Tai Mrs Kay Talbot Mr Edwin Tan Dr Philip Tan Dr Thean Hsiang Tan Dr Andrew Tan Dr Colin Tang Dr Renea Taylor Mrs Jennifer Thompson A/Prof Damien Thomson A/Prof Guy Toner Ms Patricia Townsend Dr Ben Tran Dr Yen Tran Dr Simon Troon Mr Andrew Troy Dr Sandra Turner Dr Craig Underhill Prof Jane Ussher A/Prof Celi Varol Dr Ian Vela Ms Vicki Velonas A/Prof Rosalie Viney Mr Justin Vivian Dr Mark Voskoboynik Mr Michael Wallace A/Prof Euan Walpole Ms Wendy Watts Mr Sydney Weinstein Dr David Wetherell Prof Kate White A/Prof Scott Williams Dr (Andy) Chuk Moon Won Dr Lih-Ming Wong Dr Tim Wong A/Prof Henry Woo Dr Addie Wootten Dr Miranda Xhilaga Prof Patsy Yates Dr Trina Yeadon A/Prof Desmond Yip Dr Sonia Yip Dr Chew - Lin Yip Dr Nikolajs Zeps Dr Rachel Zordan
If you are unable to identify a proposer and/or seconder please contact ANZUP who may be able to assist you.
Do you give permission for your name to appear on the list of proposers and seconders?
In accordance with rule 6.1 of ANZUP’s constitution and the Corporations Act 2001 (Cth) all members of ANZUP are required to agree to the following Guarantee *: I agree to be a member of the Company with effect from the date of this application. In accordance with the constitution I guarantee that in the event of the Company being wound up while I am member of the Company or within one (1) year after I cease to be a member of the Company, I will contribute an amount not exceeding $50.00 for payment of the debts and liabilities of the Company including the costs of winding up.