Residency Showcase at Annual Convention 2022

1
Program Information* This field is required.If multiple sites, enter the first site here
Program/Site 1 Title
PGY-1 Community Based Pharmacy Residency
Residency/Fellowship in Association Management
PGY-1/PGY-2 Combined Program
Fellowship or Unaccredited Residency
Other
Program/Site 1 Classification
Program/Site 1 City
Program/Site 1 State
Yes
No
This site has multiple locations
2
Site 2 Information
Site 2 Title
PGY-1 Community Based Pharmacy Residency
Residency/Fellowship in Association Management
PGY-1/PGY-2 Combined Program
Fellowship or Unaccredited Residency
Other
Site 2 Program Classification
Site 2 City
Site 2 State
Yes
No
This site has additional locations
3
Site 3 Information
Site 3 Title
PGY-1 Community Based Pharmacy Residency
Residency/Fellowship in Association Management
PGY-1/PGY-2 Combined Program
Fellowship or Unaccredited Residency
Other
Site 3 Program Classification
Site 3 City
Site 3 State
Yes
No
This site has additional locations
4
Site 4 Information
Site 4 Title
PGY-1 Community Based Pharmacy Residency
Residency/Fellowship in Association Management
PGY-1/PGY-2 Combined Program
Fellowship or Unaccredited Residency
Other
Site 4 Program Classification
Site 4 City
Site 4 State
Yes
No
This site has additional locations
5
Site 5 Information
Site 5 Title
PGY-1 Community Based Pharmacy Residency
Residency/Fellowship in Association Management
PGY-1/PGY-2 Combined Program
Fellowship or Unaccredited Residency
Other
Site 5 Program Classification
Site 5 City
Site 5 State
Yes
No
This site has additional locations
6
Website Link to Program Information (optional)
7
Point of Contact* This field is required.
Point of Contact First Name
Point of Contact Last Name
Please enter the point of contact's email
Please enter a number
8
Program Director* This field is required.
Program Director First Name
Program Director Last Name
Program Director email
9
Exhibitor 1 Information* This field is required.Will be on-site at the Annual Convention in Kansas City, MO
First Name
Last Name
Position/Title
Please enter your email
Yes
No
Are there additional exhibitors?
10
Exhibitor 2 InformationWill be on-site at the Annual Convention in Kansas City, MO
First Name
Last Name
Position/Title
Please enter your email
Yes
No
Are there additional exhibitors?
11
Exhibitor 3 InformationWill be on-site at the Annual Convention in Kansas City, MO
First Name
Last Name
Position/Title
Please enter your email
Yes
No
Are there additional exhibitors?
12
Exhibitor 4 InformationWill be on-site at the Annual Convention in Kansas City, MO
First Name
Last Name
Position/Title
Please enter your email
13
Questions/Comments
14
Are you interested in participating in NCPA's Virtual Residency Showcase (Date TBD). Separate registration required.
YESNO
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