If you are renewing your membership, please login to have your information pre-filled

Join or Renew your Membership

Your membership in the Alaska Pharmacists Association will assist us in our efforts to educate public agencies, policy-makers, and community members about the issues that affect the delivery of pharmacy services. Among the many benefits of membership, you'll receive discounted Continuing Education Classes, reduced Convention Registration, and our newsletter designed to keep the pharmacy professional up to speed on issues that affect our profession. Membership Fees are not refundable

Personal Information
First Name
Last Name
E-mail Address
Mailing Address
City
State
ZIP:
Home Phone
Work Phone
Fax Number
NABP e-profile id#
AK Driver's License#
Date of Birth
Professional Information
Employer
Work Location (City)
State
ZIP:
Legislative House District
Legislative Senate District
t
Please Check One of the Following

Retail Pharmacist

Institutional Pharmacist

Public Health Pharmacist

Technician

Sales Representative

Other:

Select Membership Type

Pharmacy/Corporation Membership:

    Corporate Membership – $1,500
    Business Membership – $300

Individual Membership

    Pharmacist Membership – $225
    Pharmacist 1st Year Graduate – $125
    Associate (non-pharmacist) – $150
    Technician – $50
    Pharmacy Student – $25
AKPhA Academy of Health-System Pharmacy Membership (Must be a member of AKPhA)
    Pharmacist – $25
    Technician – $10

Committee Participation

Please indicate if you'd like to participate on one of our committees, or reconfirm your commitment to your current committee so we can keep our records updated. Thank you for your support and participation!

Awards

Community Relations

Legislative

Membership

Public Relations/Advertising

Scholarships/Silent Auction

Convention/Continuing Education

Academic/UAA

Technician Advocacy

Nominations/Board Development

AkPhA may occasionally photograph our events and may use your name and/or photographic representation in the promotion of our programs. Please check this box if you DO NOT authorize this use:
     Do Not use my name or photograph
Membership Auto Renewal Option
    One-time only
    Auto Renew me each year
    Effective I authorize AkPHA to renew my annual membership and bill the credit card
    indicated below each year until I notify AkPHA otherwise. Membership will be renewed for Jan 1 - Dec 31.

Dues and contributions are not deductible as a charitable contribution for income tax purposes, but may be deductible as ordinary business expenses, subject to IRS restrictions. AkPhA estimates that 45% of your dues dollar is non-deductible because of AkPhA's lobbying activities on behalf of its members.

Donation Amount
    $ Scholarship Donation Amount – Allows the Association to encourage careers in pharmacy.
    $ Legislative Fund – Allows the Association to provide an effective advocacy voice in Juneau
    $ General Donation – Supports the Association in general operations and growth
Payment Information
Credit Card Number

Credit Card Expiration
 /    CVV:
CVV is a 3 digit number on back of your card
Credit Card Type
Please type the word at right:

Not readable? Change text.
 


Privacy Statement
: Alaska Pharmacists Association will not disclose your personal information to third parties without your written consent.