05/27/2013: Approved Committee Project Communication Request

Submit a Communication Request for Approved GCPA Projects or Events

GCPA Event Planning Checklist and Communications will be Updated Accordingly
Please complete as much of this form as possible. Some fields may not apply. This form can be resubmitted as new information becomes available.
Event Details
Official Event Title
GCPA Calendar
Event Description
Event Date

Month Day Year
Start Time

: Hour Minutes AM/PM Option
End Time

: Hour Minutes AM/PM Option
Event Location

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Special Instructions for Location
Member Cost
Non-Member Cost

Event Planning Checklist

Completed

Needs to be Completed

Not Applicable

Venue Reserved

Food and Refreshments Selected

GCPA Banner Reserved

GCPA Membership Check

Exhibitors Scheduled

Continuing Education Event Details
No. of CE Hrs
Available To:

Pharmacists Technicians
Name of Exhibitor(s) and Company
Food and Refreshments
Membership Communication Details
Select up to four dates for Local Pharmacy News Blast communications, which are sent once per week, typically on Tuesday, via fax to local pharmacies and via e-mail to members. Historically, events have been advertised on three separate dates via local pharmacy fax blast and e-mail to members. However, this can be flexible.
Date 1

Month Day Year
Date 2

Month Day Year
Date 3

Month Day Year
Date 4

Month Day Year
Date 1 Method
Date 2 Method
Date 3 Method
Date 4 Method
Are there any documents related to this event such as flyers or registration forms?
Is there a photo you would like to use for this event in the registration form and on Facebook?
Check all that apply for this event:

List on GCPA Calendar List on MPA Calendar Create Event on GCPA Facebook Create Online Registration Form (JotForm)
Committee Representative
Your Name

First Name Last Name
E-mail
Phone Number

Area Code Phone Number
Should be Empty:

Submit a Communication Request for Approved GCPA Projects or Events