Thank you for your interest in the Commission on Cancer (CoC).

Completion of this application begins the process of becoming a CoC accredited program. Please make sure you have reviewed the CoC Standards Manual and accreditation information prior to submission.

Please complete the following information about your site to begin your application.

Please note:

Federal Employer Identification Number (FEIN): asks for your facility’s unique 9-digit number assigned by the Internal Revenue Service (IRS) to all businesses operating in the United States. This number may be referred to as a tax ID number.

Site Name:

Site Address:

Country:

City:

State:

ZIP:

Web Site:

Phone: (Country Code/Area Code/Number)

Ext:

Fax: (Area Code/Number)

Site Email:

FEIN:

NPI:

AHA Number: