2022 PANL Virtual CE Program REGISTRATION FORM "*" indicates required fields CONTACT INFORMATION* Required FieldName* First Last License # (License Number is Required to Purchase at PANL Member Rate) NOTE: If not a PANL member please enter N/AXX-XXX Telephone Number*Email* Mailing Address* Address City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Select:* Purchase as Member $140 Purchase As Non-Member $275 Purchase as PANL Student Member $0 Please complete the Session 4 options below (virtual and in-person event): Session 4 (full bundle): 2SLGBTQIA+ Allyship in Pharmacy: Demonstrating Commitment to Health Equity Through Meaningful Change*Friday, October 14, 2022 5:00 p.m. to 8:00 p.m. NST Presented by:Rheya White BSc. Pharm, RPh Attending Virtually Attending In Person Not Attending this session HiddenTerms & ConditionsPlease read and understand the important information regarding the PANL Virtual CE Program and accept the terms and conditions of registration.*Important Information: PANL Virtual CE Program Policies Definitions: Regular member: Regular member: refers to those with active PANL Membership – regular, associate, supporting, honorary Student Member,: refers to MUN School of Pharmacy students with active PANL student membership. MUN Students (and students from other institutions) that are not PANL members must register at the full non member rate. While registration for MUN student members is free-of-charge, advance registration is required as per the noted registration deadlines. Non-member: refers to any individual without active PANL membership. Pharmacy Technicians: are eligible to register at the non-member rate Cancellation/Refunds: • Session dates are subject to change. • Registration fees are non-refundable. Deadline to Register: • Deadline to register is Thursday, September 28, 2022 • Individuals wishing to register for the Virtual CE Program beyond 4:00 p.m. Tuesday, October 4. must purchase the full program – individual sessions cannot be purchased beyond 4:00 p.m. Tuesday, October 4 PANL members must register in advance for the Virtual CE Program. Recorded CE sessions will NOT be available to members who did not register for the Virtual CE Program and registrations will not be accepted at a later date. Recorded Sessions: • Whenever possible, sessions will be recorded and made available online for registered participants to view until November 30, 2022. Sessions will then be removed and will no longer be available – there are no exceptions. • Sessions will then be removed and will no longer be available. • Any sessions not able to be recorded will be noted on the Conference program. Separate Recording of Sessions Separate recording /distribution of PANL sessions by presenters or attendees is not permitted. Virtual CE Program Pricing: Sessions may be purchased separately or at a ‘full program’ discount. All prices subject to HST 1-hour sessions: Regular Member: $20 Non-Member: $50 Student Member: No Cost 3-hour sessions: Regular Member: $30 Non-Member: $75 Student Member: No Cost Full Program: Regular Member: $140 Non-Member: $275 Student Member: No Cost 2SLGBTQIA+ Healthcare Session and panel discussion This session is being offered in-person as well as part of the Virtual CE Program. Individuals registering for this session will have to select their preferred option when registering. Please note: Virtual option: Those choosing the virtual option will not have the ability to interact with the speakers (pose questions). Participants will be able to view the session live and will receive the video recording. In-person option: Those attending the in-person option will have the ability to interact with the speakers (pose questions). Those noted as in attendance at the venue will receive a refund of the $30 session fee as the in-person session is being offered free-of-charge. Refunds will be issued following the conclusion of the Virtual CE Program. Those registered for the in-person session will also receive the video recording. I have read and agree to the PANL Virtual CE Program PoliciesHiddenPaymentMember Purchase* Price: Non Member Purchase* Price: Student Membership* Price: Tax $ 0.00 CAD Total Credit Card*Card Details Cardholder Name PhoneThis field is for validation purposes and should be left unchanged.