Registration

To request placement in CancerLifeline classes, please fill out the form below.

First Name (Required)

Last Name (Required)

Primary Phone (Required)

Please enter a valid phone number. This is how we will reach you if a class is changed or cancelled.

Secondary Phone

If you'd like to include an additional phone number where we can reach you, please do so, but this is not required

Your E-Mail Address

Zip Code (Required)

Should be 5 digits (e.g. 98103)

Please do not identify yourself as a Cancer Lifeline employee if you contact me by phone

I will need special accommodations; please contact me.

Please send me a catalog of your upcoming classes

Mailing Address

Would you like to receive a Cancer Lifeline Class Catalog in the mail every four months? If yes, please provide a current mailing address below even if you believe we have it.

Street Address

City

State

Cancer Lifeline services are free of charge and are made possible primarily through individual donations.

A gift to Cancer Lifeline can have a positive impact for thousands of people living with cancer in Washington State.

Your donations are tax deductible.
Tax ID #91-6182951

If you have a TisBest gift card that you would like to use for Cancer Lifeline please click this link and search for us by name.