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PDC CE Registration form
Thank you for registering for the annual Phi Delta Chi Continuing Education Event. As a reminder, the cost of registration for pharmacists is $80 ($60 if a PDC member), pharmacy technicians is $40, and students are $20.
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* Indicates required question
Name (first and last)
*
Your answer
Email
*
Your answer
PDC Member?
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Yes
No
Phone Number
*
Your answer
Address
*
Your answer
Date of Birth (Month and Day)
*
Your answer
NABP Number
Your answer
Title
*
Pharmacist
Pharmacy Technician
Pharmacy Student
Other:
Are you registering for the full day CE Event on Saturday March 19th?
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Yes
No
If you chose "No" above, please indicate how many hours of CE credit you would like to pay for and which sessions you plan to attend.
*
Your answer
The following link can be used to pay for your registration:
https://square.link/u/328Eu57h
Your answer
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