2025 Pharmacy Legislative Day Onsite Registration

Basic Contact Information

First
Middle
Last
Credentials
Preferred Email
(This is the email address that will be used to receive your registration confirmation, as well as future OPA communications.)
Mobile Number
Emergency Contact
Emergency Mobile Number
Dietary Restrictions

Home Address

Address
City
State
Zip

Work Address

Address
City
State
Zip
Work Phone

Registrant Type & Fee


Optional Support

 

PAC Contribution

If you’d like to make a voluntary contribution to the Ohio Pharmacy PAC, OPA’s political action committee, please fill in the amount in the space provided below. (Personal contributions only.)

PAC Contribution Amount$
I affirm that my OPA Pharmacy PAC contribution has been made with non-corporate funds.

OPF Contribution

If you’d like to consider making a charitable contribution to the Ohio Pharmacists Foundation (OPF), please fill in the amount in the space provided below.

LDF Contribution Amount$

Questions? Please contact us at opa@ohiopharmacists.org or (614)389-3236.
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