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AGS26 Pharmacy Credit Application
This application is only for pharmacists. Please do not complete it if you are not a pharmacist. You must have an NABP ePID number.
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1.
What is your first name?
(Required.)
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2.
What is your last name?
(Required.)
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3.
What is your email address?
(Required.)
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4.
Street address:
(Required.)
5.
Street address (line 2):
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6.
City:
(Required.)
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7.
State
(Required.)
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8.
Zip Code:
(Required.)
9.
Position / Title
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10.
NABP ePID – (needed for ACPE)
(Required.)
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11.
What month were you born? Please enter as a number, not text (e.g. enter 12 for December). (needed for ACPE)
(Required.)
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12.
What day were you born on (e.g. 19)? (needed for ACPE)
(Required.)
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13.
How many credits did you earn from the live sessions at AGS26 (maximum of 20.5)
(Required.)
Current Progress,
0 of 13 answered