JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Purdue University Pharmaceutical Industry-Affiliated Fellowships 2021-2023
Interest Form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Pharmacy School
*
Your answer
Email Address
*
Your answer
Year in School
*
P4 (Class of 2022)
P3 (Class of 2023)
P2 (Class of 2024)
P1 (Class of 2025)
Option 5
Other:
Which track(s) are you interested in?
*
FDA/Industry - Drug Information
FDA/Industry - Medication Safety
Cerevel - Global Medical Affairs
Cerevel - Global Regulatory Sciences
Takeda - Global Regulatory Affairs - Drugs and Biologics
Takeda - Global Regulatory Affairs - Labeling
Takeda - Global Clinical Operations
Takeda - US Medical/Medical Science Liasion
Required
Tentative Webinar Interest Date
*
Tuesday, October 12 at 6:00pm EST
Thursday, October 21 at 8:00pm EST
I am interested, but I cannot attend either webinar
Required
How did you hear about the Purdue University Pharmaceutical Industry-Affiliated Fellowships?
*
Select all that apply.
Email
IPhO events or resources
Purdue Pharmacy Practice Website
Referral from a friend, colleague, etc.
Instagram
Facebook
LinkedIn
Twitter
ASHP Midyear Personnel Placement Service (PPS)
Other:
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
