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First Name
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Middle Name or Initial
Last Name
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Salutation
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Name (if changed since fellowship)
Nickname (if applicable)
Job Title
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Office Phone (xxx-xxx-xxxx)
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Preferred Email Address
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Street Address
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Preferred Method of contact (check all that apply)
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Home phone
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1st Degree
School
2nd Degree
School
3rd Degree
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AFPE Award(s) Received
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Pre-Doctoral Fellowship in Pharmaceutical Sciences
Pre-Doctoral Fellowship in Clinical Pharmaceutical Sciences
Pre-Doctoral Fellowship in Pharmaceutical Sciences (for Underrepresented Minorities)
Kappa Epsilon - AFPE First Year Graduate School Fellowship
Phi Lambda Sigma - AFPE First Year Graduate School Fellowship
Rho Chi - AFPE First Year Graduate School Fellowship
Gateway to Research Scholarship
Faculty Development Fellowship
New Investigator Program (NIP)
Springboard
Other
Other
Area(s) of Expertise
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Accomplishments
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Memberships (check all that apply)
Accreditation Council for Pharmacy Education (ACPE)
American Association of Colleges of Pharmacy (AACP)
American Association of Pharmaceutical Scientists (AAPS)
American Pharmacists Association (APhA)
American Society of Health-System Pharmacists (ASHP)
Biotechnology Industry Organization (BIO)
Consumer Healthcare Products Association (CHPA)
Generic Pharmaceutical Association (GPhA)
Healthcare Distribution Management Association (HDMA)
National Association of Boards of Pharmacy (NABP)
National Association of Chain Drug Stores (NACDS)
National Community Pharmacists Association (NCPA)
Pharmaceutical Research and Manufacturers of America (PhRMA)
United States Pharmacopeial Convention (USP)
If you have any questions or need assistance, please contact us at info@afpenet.org or 703-875-3095.
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