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www.ccmac.org
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Thank You for Your Support!
To learn more about the CCMAC Instant Rewards card program, click the card image above.
* If you do not activate your CCMAC Instant Rewards card first, you will not be able to create an account with Infinity Rewards.
Enter Your Rewards Card Number here
:
1. Please indicate your age group.
Under 18
18-30
31-40
41-50
50+
2. Please indicate your sex.
Male
Female
3. Please indicate your ethnic background.
Caucasian
Person of Color
Other
4. What type of Skin Cancer was diagnosed in your family?
BaselCell
Squamous Cell
Melanoma
Not Applicable
5. Who was it diagnosed on?
Yourself
Spouse
Sibling
Parent
Aunt
Uncle
Cousin
Child
6. For Sun Protection, do you use sunscreen?
Yes
No
Do you:
a. Wear a hat?
Sometimes
Always
Never
b. Wear a shirt?
Sometimes
Always
Never
c. Wear sunglasses?
Sometimes
Always
Never
7. Have you ever used a tanning parlor?
Yes
No
a. If yes, how often
Monthly
Weekly
Sometimes
8. Do you know UV Rays from Sun or Tanning Parlors increase risk of skin cancer?
Yes
No
9. Would you like to join CCMAC's efforts for Prevention & Early Detection of Skin Cancer?
Yes
No
if so, contact us:
cmbc1@optonline.net
If your organization would like to learn more about how to develop a customized Instant Rewards Card program, please contact Touch Tone Media via email:
cory@touchtonemedia.net
or call 1-888-331-3398