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Industry Pharmacists Organization (IPhO)
Membership Sign Up Form
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* Indicates required question
Full Name
*
Your answer
KGI Email
*
Your answer
Class
*
P1
P2
P3
P4
Are you a paid KGI chapter member? ($35)
*
Yes
No
Are you a paid KGI & paid national member? ($10 to KGI chapter member + proof of paid national registration [email
dsalinas18@students.kgi.edu
with registration information])
*
Yes
No
Have you signed up for a FREE guest account with the national organization? (email
nkuriki19@students.kgi.edu
with registration information)
*
Yes
No
Are you a paid national IPhO member? ($99)
*
Yes
No
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