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Apply to Become an NCCC Chapter Leader

NCCC Chapter Leaders take the lead in bringing cervical health awareness to their communities through education, outreach, events, and fundraising. 

With a commitment of about 5–10 hours per month, this role is perfect for someone who enjoys organizing events, leading local efforts, building connections, and rallying others around a meaningful cause.

As a leader, you’ll receive all the perks of being a chapter representative, plus the opportunity to raise funds that directly benefit your community. With guidance and support from NCCC, you can help expand access to education, resources, and support services for those affected by HPV and cervical cancer.

Ready to become a leader? Complete and submit the application below.

Chapter Leader Application
Your Name
Your Name
First Name
Last Name
Address
Address
City
State/Province
Zip/Postal
0 of 300 max characters

As a chapter leader, you agree to uphold the NCCC Code of Conduct. Violations may result in suspension or termination of your role and loss of chapter privileges.

You must always:

—Speak truthfully and accurately.

—Disclose your affiliation with ASHA/NCCC in all chapter-related activities.

—Avoid giving medical advice. Clarify that you are sharing personal experiences or opinions only.

—Remind others that only physicians can prescribe medications or determine treatment.

—Speak only about the FDA-approved (“on-label”) uses of medications.

—Respect others’ right to form their own opinions based on the information you share.

—Protect privacy—never share personally identifiable health information.

—Involve minors (under 18) only with the direct participation of a parent or legal guardian.

If concerns arise regarding donation management, the ASHA/NCCC Admin team may issue a warning. Chapters may be suspended or terminated at the discretion of the ASHA CEO following such warnings.

Acknowledgement