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MPSA Post-Event Form (2025-2026)
Please fill out this form after every event or general meeting that you plan within MPSA. Don't forget to take pictures at your event and upload them to the Google Drive listed below, we'd love to see them! Thank you!

Google Drive: https://drive.google.com/drive/folders/19Fw9zQYlsmJx8Wy40fDmcaGJeYDKBQQL?usp=drive_link 
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Email *
Name *
Your leadership position within MPSA *
Names of additional members that planned the event
Campuses Involved *
Name of Event/Activity/Meeting/Project *
Examples: For an individual event - APhA-ASP Chapter Meeting: Professionalism Speaker, For a month long program - HPV Awareness Campaign during American Pharmacist Month, For recurring events or meetings - IPhO Chapter Meetings
Classification of Event *
Check all that apply
Required
Date of Event *
MM
/
DD
/
YYYY
Dates of Events (if recurring)
Month, day, year for each recurring meeting/event
Location of Event *
Promotional Materials used for event (advertising): *
If "Other," be specific. Examples: Governor's proclamation, Walgreen's reader boards, HPV awareness letter, HPV Public Service Announcements, web sites
Required
Target Audience *
Example: College of Pharmacy Students, Pharmacists and Faculty, Citizens of State, Chapter Members
Number of Faculty Present *
Number of Additional Pharmacists Present *
Number of Chapter members Present *
Number of Patients that attended *
Number of Patients screened *
Number of patients that received wellness/clinical services *
This may include blood glucose testing, bone density testing or referral references
Number of Patients reached through public relations *
Estimate based off of promotional materials used for advertising and target audience.
Event type *
If the event is continuing from previous years, how many years has it taken place (if known)?
Total number of hours for event planning? *
Total number of hours for event? *
Organizations Collaborated With *
All MPSA initiatives, school initiatives, and community initiatives need to be included. If a Health Fair, include all operations/organizations that were there. Examples: State Pharmacy Association and SSHP Chapter, NCPA, or none
Synopsis *
Must be ≤75 words and written in third person
Please upload photos of educational material, photos of members at the event, etc., here: 
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