Caribbean Association of Pharmacists Conference Registration 2019
This form is designed to enable the registration of persons who are interested in attending the 39th Annual Convention of the Caribbean Association of Pharmacists (Orlando, FL) between 12th and 19th August, 2019.
Please complete all the fields as far as possible and click Submit when done. Payment is required to complete your registration.

If you have any queries, you may contact the CAP Office by email at thecapoffice@gmail.com, and copy to Mrs. Pamela Townsend, Executive Director at ptown39@hotmail.com.

REGISTRATION FEES for Pharmacist Members:
April 2019: $450 USD
May 2019: $550 USD
June 2019: $650 USD
July - 12th August, 2019: $700 USD
Onsite: $800 USD

For Non-members: Add $150 USD to the respective Registration Fee

Accompanying Guest (for social activities only): $250 USD
Accompanying Guest (lunch and social activities): $350 USD
Note: Guests are not entitled to attend CE sessions.

STUDENT REGISTRATION FEES:
April - May 2019: $ 375 USD
June - 12th August 2019: $500

MEMBERSHIP DUES:
Tier A: $30 USD
Tier B: $50 USD
Membership is FREE for pharmacy students.

Information for Membership Tiers may be found at:
https://ww2.cap-pharmacists.com/2019/04/09/cap-new-membership-dues-structure-2019/

(Copy and paste the link into a new window)

Payments may be made by credit card, or bank draft to The Caribbean Association of Pharmacists or via direct deposit. Contact Mrs. Townsend for details for mailing cheques and wire transfers.

Email address *
Are you a member of CAP? *
Surname / Family Name *
Your answer
Given Name: *
Your answer
Name of Accompanying Person
Your answer
Your Mailing Address *
Your answer
Country of Current Pharmacist Registration or Pharmacy School *
Your answer
Telephone (work) *
Your answer
Telephone (mobile) *
Your answer
Telephone (home)
Your answer
Name of Next of Kin *
Your answer
Contact number / email for Next of Kin *
Your answer
Special Needs: Dietary or other
Your answer
Please select the registration type that applies to you: *
If you will be paying your membership dues, or paying for an accompanying guest, please indicate by selecting the appropriate option(s): *
Required
Please indicate the total amount, in USD you will be paying: *
Your answer
Thank you. To complete your registration, payment may be made via credit card online at https://ww2.cap-pharmacists.com/make-payment, or via bank draft payable to The Caribbean Association of Pharmacists (to be sent via postal services), or via direct deposit. Contact Pamela Townsend for details at: ptown39@hotmail.com.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service