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ISPOR Student Chapter
Webpage Update Form
Please complete the information below and email it to Stacey Mauriello at smauriello@ispor.org
.
When complete, save the word document under a new file name that identifies the sending institution. Please forward the University logo (if the logo is not on file from previous years. To determine whether or not your school’s logo is on file, please go here to find you school in the list of
Student Chapters) and the Student Chapter Picture as attachments. If you are having difficulty with the logo or picture, please send the information that you do have.
Student Chapter University:
Year Established:
Contact Information of the Institution (Include mailing address & contact name/telephone number):
Mission Statement:
Chapter Picture:
2 Additional Pictures May Be Uploaded (optional):
Current Officers:
Name E-mail
President
Vice-President
Treasurer
Secretary
Faculty Advisor
Members (alphabetical list and e-mail):
Members characteristics (not to go on website, for demographic purposes only)
Number of chapter members in PhD program:
Number of chapter members in MS program:
Number of chapter members in PharmD program:
Number of active members in chapter (active members are those who regularly attend chapter functions):
Scheduled Events (Include tentative date):