Registration Pharmacy_Feb

1. HIV Education for the Pharmacist

Thank you for registering for the BASIC SCIENCE of HIV webinar to be held on Friday, February 17, 2012, from 12:00 - 1:00 pm.

Please provide the following information: First Name:
Last Name:
Agency:
Address:
City/Town:
State:
ZIP:
Email Address:
Phone Number:

Would you like to pose a question for the presenter to answer on the day of the program? If so, please indicate below: