Webinars

Section I – Demographic Information
Name*
First Last
Credentials
Company/Employer
Are you a CPhA Member?*
- No
- Yes
Please enter your full member ID number*
Preferred Mailing Address*
Street Address Address Line 2 City State Zip Code
This is my:*
- Home Address
- Business Address
Preferred Phone Number*
This phone number is my*
- Cell
- Home
- Work
Email Address*
Tell us about your background and your speaking experience:*
Provide links to your website and video clips of you delivering an education program, if available. (We're not looking for a professionally-produced, fancy video that tells us about you. What's important is that we get a sense for what you're like in action when leading an education program.)

Section II – Program Information
Please plan for a 60 minute presentation.
Program Type*
- Standard Presentation (1 speaker)
- Panel Presentation (2 or more speakers). Please enter the names and contact information of the other speakers:
Program Activity Type*
- Knowledge-based (designed primarily for pharmacists and technicians to acquire factual knowledge. This information must be based on evidence as accepted in the literature by the health care professions. The minimum credit for these is 15 min or 0.25 contact hour.)
- Application-based (designed primarily for pharmacists and technicians to apply the information learned in the time frame allotted. The information must be based on evidence as accepted in the literature by the health care professions. The minimum credit for these activities is 60 minutes or one contact hour.)
Program Title*
Program Description
Please provide a brief program description (max 100 word) to promote your program in the marketing materials (should your program be selected). *
Please provide an outline of your program listing each topic area you will cover and include a timeframe for each.*
Please provide 3-5 measurable learning objectives for each hour of your program. *Visit http://tiny.cc/LOs for a guide on developing educational objectives.*
Target Audience (e.g. pharmacy staff, consultants, managers, directors, and executives from specialty pharmacy providers, infusion pharmacies, pharma/biotech manufacturers, managed care organizations, group purchasing organizations, institutional pharmacies, distributors and suppliers, etc.)*
Curriculum Vitae (CV) & Biosketch Curriculum Vitae (CV) & Biosketch A CV is required to help us ensure that our continuing pharmacy education program speakers are competent in the subject matter and qualified by experience and/or training. The biosketch will be used as your introduction, should your program be selected.*
Max. file size: 256 MB.

CPhA Webinars - Call for Presentations

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Section I – Demographic Information

Section II – Program Information

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