Women in Pharma® Intake Form

ISPE Boston Women in Pharma

ISPE Boston Women in Pharma® Intake Form

We are grateful for your interest in the ISPE Boston Area Chapter's Women in Pharma® Committee. In order to make the most of your time we would like to understand the level you would like to participate in the group and tailor communications to you.

Personal Information

Please enter your contact information below. Note: we will not share your contact info outside of ISPE Boston.

First Name *

Last Name *

Company/School

Phone *

Email Address *

1) How did you hear about the Women In Pharma® (WIP) Boston Chapter?

2) Are you currently an ISPE member? *

Note that membership in the Women in Pharma® subcommittee is a benefit for ISPE members.

3) How many years of Pharmaceutical/Biopharm experience do you have?

Tell us if you are interested in:

Click all that apply

Joining the Planning Committee for Boston of Women in Pharma®?

Interested

Approx. level of commitment: Attend Monthly planning meetings/calls, Assist in planning events, Attend majority of WIP Events, etc.

Day of Event Volunteer?

Interested

Approx. level of commitment: on the day of the event to arrive early and/or stay late to support in your assigned role

Please select the types of communications from Boston Women in Pharma that you would prefer:

Receive "Call for Volunteers" and other WIP update e-mails?

Interested in ONLY receiving information on upcoming Boston WIP events to attend?

No interest in further communication from Boston WIP? (We will remove your contact information from our contact list)

Click all that apply

We greatly appreciate your interest in joining Women in Pharma® and sincerely hope to get to you know you better through Boston WIP!

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