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2023-2024 “Pharmacy Kannected” Registration
Thank you for your interest in our program!
This year's program goals:
Engage members to enhance networking and career opportunities
Create continuous dialogue between members for new ideas and lifelong learning
Develop a community that provides meaningful support and guidance to all members
Questions? saige.dixonpeters@gmail.com
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First and Last Name
*
Your answer
Preferred Email (Non-KU)
*
Your answer
Phone Number
Your answer
Employer information (if applicable), including department, position or specialty
Your answer
What are some of your passions in pharmacy, medicine, or healthcare?
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Your answer
What makes“Pharmacy Kannected” appealing to you?
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Your answer
What would you like to get from the “Pharmacy Kannected” experience?
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Your answer
What hobbies do you like to partake in?
Your answer
What times are best available for meeting?
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Monday through Friday throughout the day
Monday through Friday in the evening
Monday through Friday during the noon hour
Weekends during the days
Weekends during the evenings
Other:
Required
Are you a student?
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Yes
No
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