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Wednesday, March 10, 2010 Login To My CPF  or  Register Today
 
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Provide the following information to access the grant application and managemet area, discuss forums and CPF commentary made available through The Community Pharmacy Foundation and this web site. Login instructions will automatically be sent to your email address for future access to My CPF.

If you are applying for a grant today, indicate so below and you will automatically continue to the application form.


Free Registration (Fields are in red are required)


  First Name  Middle Initial   
  Last Name
  Prof. Credentials   (ie: Ph.D., Pharm.D., R.Ph.)
  Email Address *Will be your login to My CPF
  Forum Nickname *Will be used to identify you in CPF Discussion Forums
  Password
  Password (Confirm)
  Remember Me? Automatically log me in on my next visit from this computer.

Additional Information (Fields are in red are required)

1. I am a pharmacist (also answer below)    I am a not a pharmacist
 
  My initial pharmacy degree was earned from:
 
  Year received: 
2. Current Practice (Select all that apply):
  Community Pharmacy (pick 1): Chain   Independent   Supermarket   Mass Merchant
  Hosital Pharmacy
  College of Pharmacy
  Other - Describe: 
  Not a pharmacist
3. How many years have you been a licensed pharmacist?
4. In what U.S. state or territory is your current place of employment?
  US State or Canadian Providence 
  Country 
5. Which of the following population size categories best describes your current work location?
  Urban counties (Includes urban core and suburban areas – greater than or equal to 50,000 people)
  Large Town counties (10,000 – 49,999 people)
  Small Town counties (less than or equal to 9,999 people)
6. Please indicate your gender: Male     Female
7. Please indicate your age range:
8. How did you learn about this site?
    Other:
9. Are you applying for a CPF Grant today? Yes, I want continue with my online grant application.*
    No, I do not wish to apply for a grant at this time.

After submitting this form you will receive an email confirming your registration.
Please follow the instructions in that email to complete your free registration and gain access to MyCPF.
  *If you indicated you are applying for a CPF Grant online, you will automatically continue with Step 2 - your grant project details.

 

  
 
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