IASLC International Staging Project Database Account Change Form
Please use this form to update your account information. The name of the project (Lung Cancer, Mesothelioma, and Thymic Malignancies) and the name of institution are required fields; however, it is not necessary to enter the address or fax number unless this information has changed. Likewise, please enter only the specific users for whom changes are being requested. GCCB-II/GCCB-III membership applies only to institutions located in Spain.
Please indicate the project in which you are participating. If you are participating in multiple staging projects, please submit a separate form for each disease site.
Lung Cancer
Mesothelioma
Thymic Malignancies
Institution Information
Who is submitting this form?
Title
Full Name
Email Address
Site number (if known)
Institution Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
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
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Member of GCCB-II or GCCB-III Consortium?
Yes
No
Data Entry System Users
Please note that only the Principal Investigator (or the established designate for the PI) another previously authorized user can make changes to the account.
User ID (if known)
Name
Title
First Name
Last Name
Email Address
Please make the following change to the above listed account:
Add new account
Update contact information
De-active existing account
Designate this user as the Principal Investigator
User ID (if known)
Name
Title
First Name
Last Name
Email Address
Please make the following change to the above listed account:
Add new account
Update contact information
De-active existing account
Designate this user as the Principal Investigator
User ID (if known)
Name
Title
First Name
Last Name
Email Address
Please make the following change to the above listed account:
Add new account
Update contact information
De-active existing account
Designate this user as the Principal Investigator
User ID (if known)
Name
Title
First Name
Last Name
Email Address
Please make the following change to the above listed account:
Add new account
Update contact information
De-active existing account
Designate this user as the Principal Investigator
User ID (if known)
Name
Title
First Name
Last Name
Email Address
Please make the following change to the above listed account:
Add new account
Update contact information
De-active existing account
Designate this user as the Principal Investigator
User ID (if known)
Name
Title
First Name
Last Name
Email Address
Please make the following change to the above listed account:
Add new account
Update contact information
De-active existing account
Designate this user as the Principal Investigator
Submit
Should be Empty: