Pharmacy Student Travel Grant Application Compounders on Capitol Hill 2019
Through the generosity of donors to our Fund-the-Future campaign the IACP Foundation will be offering up to two (2) pharmacy students a travel grant for $2,500 to attend the International Academy of Compounding Pharmacists’ annual meeting -- Compounders on Capitol Hill -- on May 18-21, 2019, in Washington, DC. Winners will be notified in April.

All applicants must read and comply with all official rules. For a complete list of the official rules, please visit https://www.iacprx.org/page/696.

Applications may be edited after submission. All applications must be completed by March 6th at 11:59 pm EST. After the deadline, submissions cannot be edited. Please contact the IACP Foundation at Foundation@iacprx.org with any questions.

Section 1: Personal Information
All applicant information will be kept confidential by the IACP Foundation.
First Name:
Last Name:
Permanent (Home) Address:
City:
State:
Zip:
Mobile:
Student ID:
College/University:
Campus Address:
City:
State:
Zip:
School Email:
Alternate Email:
Year in Pharmacy Program:
Anticipated Graduation:
(month and year)
Faculty Advisor (Name/Title):
Please list faculty member associated with student affairs.
Advisor Email:
Advisor Phone:
Advisor Address:
(If different from university address.)
Advisor City:
Advisor State:
Advisor Zip:
Rotation Site Preceptor (Name/Title):
Please list preceptor you will have during travel (if applicable).
Preceptor Email:
Preceptor Phone:
Rotation Site Preceptor (Name/Title):
Please list preceptor you will have during travel (if applicable).
Preceptor Email:
Preceptor Phone:
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