NMPhA Mid-Winter Meeting “PHARMACY: THE CURE FOR ORDINARY”
PROGRAM AGENDA:
Hotel Albuquerque at Old Town
Albuquerque, New Mexico
Saturday, January 23, 2016
8:00am - 1:00pm
8:00am
8:30am
Noon
1:00pm
Executive Council Meeting
Council Breakfast
Council Meeting Begins
Council Lunch
Council Meeting Adjourns
1:00pm - 3:00pm

Concurrent Programs
Law CE Program
2016 Board of Pharmacy Drug Law Update
Ben Kesner, RPh & Cheranne McCracken, PharmD
ACPE #: 0104-0000-16-001-L03-P
Contact Hours: 2.0 CEUs: 0.2 Initial Release Date: 1/23/16
To familiarize health care professionals with new and/or changes to state and federal regulation or laws and to promote
compliance with existing laws and regulations. At the completion of this knowledge-based presentation, the Pharmacist
participant will be able to: 1) Identify and describe new drug laws and regulations; 2) Identify and describe changes to
existing drug regulation and laws; 3) Identify compliance problem areas in drug laws and regulations;
4) Define the Pharmacist role in compliance with the drug laws and regulations discussed and 5) Identify drug law trends.
ACPE #: 0104-0000-16-001-L03-T
At the completion of this knowledge-based presentation, the Pharmacy Technician participant will be able to: 1) Identify
and describe new drug laws and regulations; 2) Identify and describe changes to existing drug regulation and laws;
3) Identify compliance problem areas in drug laws and regulations; 4) Define the Pharmacy Technician role in compliance
with the drug laws and regulations discussed and 5) Identify drug law trends.
Program Sponsored by: New Mexico Board of Pharmacy
1:00pm - 2:00pm
 Current Topics Regarding the Use of Psychotropic Medication in Children and Youth
ACPE #: 0104-0000-16-002-L01-P
M. Lynn Crismon, PharmD., FCCP, BCPP
Contact Hours: 1.0 CEU: 0.1
Initial Release Date: 1/23/16
At the completion of this knowledge-based presentation, the Pharmacist participant will be able to: 1) Discuss recent
advances in pharmacotherapy for youth with mental disorders; 2) Delineate current controversies regarding the use of
psychotropic medication in children and youth; 3) Describe how you would answer a question from a parent regarding
potential suicidality associated with antidepressant use in adolescents and 4) Discuss methods to improve the utilization of
psychotropic medication in children and adolescents.
ACPE #: 0104-0000-16-002-L01-T
At the completion of this knowledge-based presentation, the Pharmacy Technician participant will be able to: 1) Describe
the controversial topics regarding the use of psychotropic mediations that parents and caregivers may ask pharmacy
technicians; 2) Reflect on how you would address questions from parents and caregivers regarding the use of psychotropic
medications in children and adolescents; 3) Discuss how pharmacy technicians can best assist pharmacists in addressing
parent and caregiver concerns regarding the use of psychotropic medication in children and adolescents and 4) Consider the
ways in which a pharmacy technician can collaborate with pharmacists and other healthcare personnel to improve he
utilization of psychotropic medication in children and adolescents.
Program Sponsored by: The University of Texas at Austin College of Pharmacy
NMPhA Mid-Winter Meeting
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Hotel Albuquerque at Old Town
NMPhA Mid-Winter Meeting “PHARMACY: THE CURE FOR ORDINARY”
2:00pm - 3:00pm
Mandatory for Pharmacists prescribing Tobacco Cessation Products (One Live CE hour per year)

Increasing Smoking Cessation Rates with a Novel Pharmacotherapy: Intranasal
Insulin Development at University of New Mexico
Ajna Hamidovic, PharmD, MS
ACPE #: 0104-0000-16-011-L01-P
Contact Hours: 1.0 CEU: 0.1
Initial Release Date: 1/23/16
At the completion of this knowledge-based presentation, the Pharmacist participant will be able to: 1) Describe the process
of genetic associations analyses that led to hypothesis that insulin is implicated in the pathophysiology of nicotine
dependence; 2) Identify two mechanisms related to stress response that are targeted by intranasal insulin; 3) Discuss one
shared neural mechanism between drug addiction and eating behavior; 4) Describe the effect of intranasal insulin on
circulating free fatty acids and its possible implication in prevention of Type II diabetes and 5) Discuss whether intranasal
insulin appears to be a safe treatment for smoking cessation.
ACPE #: 0104-0000-16-011-L01-T
At the completion of this knowledge-based presentation, the Pharmacy Technician participant will be able to: 1) Identify
characteristics of Nicotine Dependence; 2) Describe three mechanisms of stress response that modulate nicotine
dependence; 3) List the direction (i.e. increase, decrease, neutral) of intranasal insulin’s effect on circulating free fatty acids
and 4) List safety outcomes collected during intranasal insulin.
Program Sponsored by: UNM College of Pharmacy
3:00pm - 3:15pm
Snack Break
3:15pm - 4:15pm
General Session
 What’s new in Type 2 Diabetes Management? New Drug Approvals and Treatment
Recommendations
Gretchen M. Ray, PharmD, PhC, BCACP, CDE
ACPE #: 0104-0000-16-003-L01-P
Contact Hours: 1.0 CEU: 0.1 Initial Release Date: 1/23/16
At the completion of this knowledge-based presentation, the Pharmacist participant will be able to: 1) Describe the most
recent drug approvals for type 2 diabetes including new insulins, DPP-4 inhibitors, GLP-1 agonists, and SGLT2 inhibitors;
2) Describe the 2015 management of hyperglycemia algorithm from the American Diabetes Association and 3) Describe
updates from the 2016 American Diabetes Association standards of care in diabetes.
ACPE #: 0104-0000-16-003-L01-T
At the completion of this knowledge-based presentation, the Pharmacy Technician participant will be able to: 1) Describe
the most recent drug approvals for type 2 diabetes including new insulins, DPP-4 inhibitors, GLP-1 agonists, and SGLT2
inhibitors; 2) Describe the 2015 management of hyperglycemia algorithm from the American Diabetes Association and 3)
Describe updates from the 2016 American Diabetes Association standards of care in diabetes.
Program Sponsored by: UNM College of Pharmacy
4:15pm - 5:15pm
General Session
 From Pubmed to Google: Evidence-Based Pharmacy Practice Using Online
Information Resources
Leslie A. McCament-Mann, PhD, RPh
ACPE #: 0104-0000-16-004-L04-P
Contact Hours: 1.0 CEU: 0.1 Initial Release Date: 1/23/16
At the completion of this knowledge-based presentation, the Pharmacist participant will be able to: 1) Explain the 4-step
evidence-based approach for resolving pharmacotherapy-related questions; 2) Differentiate the 3 categories of biomedical
information sources and their best uses; 3) List commonly accessible, credible electronic drug information resources; 4) For
a given therapeutic question, choose appropriate electronic resources, critically evaluate the evidence, and synthesize a
clinically useful response and 5) Appropriately refer some drug information requests to the New Mexico Poison and Drug
Information Center.
ACPE #: 0104-0000-16-004-L04-T
At the completion of this knowledge-based presentation, the Pharmacy Technician participant will be able to: 1) Explain
the 4-step evidence-based approach for resolving pharmacotherapy-related questions; 2) Differentiate the 3 categories of
biomedical information sources and their best uses; 3) List commonly accessible, credible electronic drug information
resources; 4) For a given therapeutic question, choose appropriate electronic resources, critically evaluate the evidence, and synthesize a
clinically useful response and 5) Appropriately refer some drug information requests to the New Mexico Poison and Drug Information
Center.
Program Sponsored by: New Mexico Poison & Drug Information Center
NMPhA Mid-Winter Meeting
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Hotel Albuquerque at Old Town
NMPhA Mid-Winter Meeting “PHARMACY: THE CURE FOR ORDINARY”
6:15pm - 9:00pm COP Students/Recent Grad ‘Social Hour & Taco Bar’
Casa Esencia – www.casaesencia.com
Light Hors d ‘Oeuvres & Refreshments served – Event co-sponsored by Cardinal Health
Sunday, January 24, 2016
7:00am – 8:00am
FREE Cardiovascular Risk Screenings … (NO CE)
If interested, schedule your appointment with the NMPhA office @ 505-265-8729/800-464-8729. The
screenings will include, a complete fasting lipid profile (includes good and bad cholesterol), blood glucose, blood
pressure, body mass index, and a 10-year risk estimate for cardiovascular disease and stroke. The cholesterol and
glucose tests require a small fingerstick sample of blood. For the most accurate results, participants should
complete a 10 to 12 hour fast (nothing to eat or drink of caloric value) prior to the screening.
This program is put on by students from the UNM College of Pharmacy.
7:30am
Pick up name badges
Continental Breakfast
8:00am - 9:00am
General Session
 2016 HIV Update
ACPE #: 0104-0000-16-012-L02-P
Bernadette Jakeman, PharmD, PhC, BCPS, AAHIVP
Contact Hours: 1.0 CEU: 0.1 Initial Release Date: 1/24/16
At the completion of this knowledge-based presentation, the Pharmacist participant will be able to: 1) Summarize key
updates to the DHHS treatment guidelines; 2) Identify recommended antiretroviral regimens for treatment-naive patients
and 3) Describe common side effects and drug interactions associated with the recommended antiretroviral regimens.
ACPE #: 0104-0000-16-012-L02-T
At the completion of this knowledge-based presentation, the Pharmacy Technician participant will be able to: 1) Define
HAART; 2) Define CD4 cell count and HIV viral load and 3) Explain why combination therapy is required in the
management of HIV.
Program Sponsored by: UNM College of Pharmacy
9:00am – 9:10am
Coffee Break
9:10am - 10:10am
Concurrent Sessions
 Hypertension Treatment: Current Guidelines and Future Directions
James J. Nawarskas, PharmD, PhC, BCPS & Joe R. Anderson, PharmD, PhC, BCPS
ACPE #: 0104-0000-16-005-L01-P
Contact Hours: 1.0 CEUs: 0.1 Initial Release Date: 1/24/16
At the completion of this knowledge-based presentation, the Pharmacist participant will be able to: 1) Identify blood
pressure goals for various populations from the latest guidelines; 2) State the drugs of choice for treating uncomplicated
hypertension; 3) State the antihypertensive drugs of choice in patients with diabetes and kidney disease; 4) Describe the
differences between previous and current hypertension guidelines and 5) State how upcoming hypertension treatment
guidelines may change based on recent clinical trial results.
ACPE #: 0104-0000-16-005-L01-T
At the completion of this knowledge-based presentation, the Pharmacy Technician participant will be able to: 1) State how
blood pressure guidelines are useful for helping to manage hypertension; 2) Identify the drugs of choice for treating
uncomplicated hypertension; 3) Identify the antihypertensive drugs of choice in patients with diabetes and kidney disease
and 4) State how upcoming hypertension treatment guidelines may change based on recent clinical trial results.
Program Sponsored by: UNM College of Pharmacy
NMPhA Mid-Winter Meeting
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Hotel Albuquerque at Old Town
NMPhA Mid-Winter Meeting “PHARMACY: THE CURE FOR ORDINARY”
9:10am - 10:10am
 Drug Seeker or Genetic Genie
Teri Rolan, PharmD, PhC
Initial Release Date: 1/24/16
ACPE #: 0104-0000-16-006-L04–P
Contact Hours: 1.0 CEU: 0.1
At the completion of this knowledge-based presentation, the Pharmacist participant will be able to: 1) Define
pharmacogenomics and pharmacogenetics; 2) Review DNA Basics; 3) Describe what a SNP is and how it relates to health
outcomes; 4) Describe how DNA mutations like SNPs and copy-number variations impact proteins ; 5) Describe how
genetic variations cause opioids to be metabolized differently and what the patient may experience when this occurs; 6)
Give other examples of drug gene interactions and when pharmacogenomic testing may be appropriate; 7) List some
limitations and ethical issues faced when using pharmacogenomic testing; 8) Distinguish what resources are available to
help you better understand pharmacogenomic testing and it’s uses and 9) Direct patients that have done Direct to Consumer
genetic testing.
ACPE #: 0104-0000-16-006-L04–T
At the completion of this knowledge-based presentation, the Pharmacy Technician participant will be able to: 1) Define
pharmacogenomics and pharmacogenetics; 2) Review DNA Basics; 3) Describe what a SNP is and how it relates to health
outcomes; 4) Recognize a potential patient that could benefit from pharmacogenomic testing and when to refer to the
pharmacist and/or doctor and 5) Recognize some of medications where testing can be useful.
10:15am - 11:15am
General Session
Mandatory for Pharmacists w/ Vaccination Prescriptive Authority (One Live CE hour per year)

Immunizations: Pharmunize Part I - Vaccine Update and Review
Amy Bachyrycz, PharmD
ACPE #: 0104-0000-16-007-L01-P
Contact Hours: 1.0 CEU: 0.1 Initial Release Date: 1/24/16
At the completion of this knowledge-based presentation, the Pharmacist participant will be able to: 1) Outline IZ
prescriptive authority protocol updates; 2) Review new ACIP recommendations and guidelines; 3) Define process for
yellow fever vaccinations in NM; 4) Define use of travel vaccines/medications using patient vignettes and 5) Determine
pharmacist impact on vaccination rates in NM.
ACPE #: 0104-0000-16-007-L01-T
At the completion of this knowledge-based presentation, the Pharmacy Technician participant will be able to: 1) Outline IZ
prescriptive authority protocol updates; 2) Review new ACIP recommendations and guidelines; 3) Define significance of
yellow fever vaccinations in NM and 4) Define NMSIIS and VFC as it relates to NM.
11:20am – 12:20pm
General Session: Pain Management/Patient Safety CPE
Mandatory for Pharmacists w/ Naloxone Prescriptive Authority (One Live CE hour per year)

Pain Management: News Flash: NM Pharmacist Saves Lives with Naloxone
Dhara Shah Lari, PharmD Candidate & Amy Bachyrycz, PharmD & Jennifer Smith, PharmD
ACPE #: 0104-0000-16-008-L05-P
Contact Hours: 1.0 CEU: 0.1
Initial Release Date: 1/24/16
At the completion of this application-based presentation, the Pharmacist participant will be able to: 1) Explain preliminary
data collected through the Naloxone Pharmacist Prescriptive Authority Program; 2) Evaluate specific trends in opioid
overdose prevention in New Mexico pharmacies; 3) Demonstrate opioid overdose as a social problem; 4) Collaborate with
others to identify areas of high opioid mortalities in NM; 5) Identify other healthcare professional’s role in decreasing
opioid overdose and 6) Assisting in next steps to decrease opioid overdose deaths in NM.
ACPE #: 0104-0000-16-008-L05-T
At the completion of this application-based presentation, the Pharmacy Technician participant will be able to: 1) Explain
the Naloxone Pharmacist Prescriptive Authority Program; 2) Evaluate opioid overdose prevention in New Mexico
pharmacies; 3) Demonstrate opioid overdose as a social problem; 4) Collaborate with others to identify areas of high opioid
mortalities in NM and 5) Assisting in next steps to decrease opioid overdose deaths in NM.
Program Sponsored by: UNM College of Pharmacy
NMPhA Mid-Winter Meeting
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Hotel Albuquerque at Old Town
NMPhA Mid-Winter Meeting “PHARMACY: THE CURE FOR ORDINARY”
12:30pm – 2:00pm
Luncheon
Installation of Officers/Awards Presentation
Introduction of 2016 Officers & Councilors
Legislative Update – R. Dale Tinker
UNM COP Update – Dr. Lynda Welage
2:00pm – 3:00pm
General Session
 The “No Fear” DEA Audit
Shirley J. Scott
Initial Release Date: 1/24/16
ACPE #: 0104-0000-16-009-L04-P
Contact Hours: 1.0 CEU: 0.1
At the completion of this knowledge-based presentation, the Pharmacist participant will be able to: 1) Learn what a DEA
audit consists of and how to prepare for one. CSA requirements will be reviewed in brief as well.
ACPE #: 0104-0000-16-009-L04-T
At the completion of this knowledge-based presentation, the Pharmacy Technician participant will be able to: 1) Learn
what a DEA audit consists of and how to prepare for one. CSA requirements will be reviewed in brief as well.
Program Sponsored by: Drug Enforcement Administration
3:00pm - 3:30pm
Ice Cream/Coffee Break
3:30pm - 4:30pm
General Session

Pain, Trauma, and Health
Krishna J. Chari, Psy.D
Initial Release Date: 1/24/16
ACPE #: 0104-0000-16-010-L04-P
Contact Hours: 1.0 CEU: 0.1
At the completion of this knowledge-based presentation, the Pharmacist participant will be able to: 1) Describe the intrinsic
link between chronic pain conditions and emotional distress; 2) Review and be able to conceptualize psychological trauma
and its impact on physical health conditions and its mutual maintenance of chronic disease; 3) Differentiate between
different types of stressors (i.e. acute, traumatic, complex traumatic), and understand the differing manifestations of stress in
psychological disorders and physical disease and 4) Identify the mind-body link between emotional stress and physical
health.
ACPE #: 0104-0000-16-010-L04-T
At the completion of this knowledge-based presentation, the Pharmacy Technician participant will be able to: 1) Describe
the intrinsic link between chronic pain conditions and emotional distress; 2) Review and be able to conceptualize
psychological trauma and its impact on physical health conditions and its mutual maintenance of chronic disease; 3)
Differentiate between different types of stressors (i.e. acute, traumatic, complex traumatic), and understand the differing
manifestations of stress in psychological disorders and physical disease and 4) Identify the mind-body link between
emotional stress and physical health.
Accreditation Council for Pharmacy Education Information
The New Mexico Pharmacists Association is accredited by the Accreditation Council for Pharmacy
Education (ACPE) as a provider of continuing pharmacy education. Pharmacists and other health
professionals may earn up to 10.0 contact hours or 1.0 CEU’s by participating and successfully
completing a program evaluation form for each program attended. NMPhA will submit the
completed CPE hours into the CPE Monitor database within 60 days to attendees who have
successfully completed a Program Evaluation Form.
NOTE: CPE credit will not be issued unless all appropriate fees are paid.
TARGET AUDIENCE: Pharmacists, pharmacy technicians and pharmacy students.
GRIEVANCE POLICY: If, for any reason, a participant is unsatisfied with one program or the entire program,
that participant must file his/her grievance, either by phone or in writing, with the NMPhA office within ten business days of
the program in order to determine the refund amount. If the individual(s) remain unsatisfied with the response from the
NMPhA Program Administrator, he/she may request to appeal the situation before the Association’s Executive Council at
the next scheduled meeting. Such an appeal may be done either in person or in writing. All expenses pertinent to such an
appeal shall be borne by the individual(s) requesting the appeal.
NMPhA Mid-Winter Meeting
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Hotel Albuquerque at Old Town
NMPhA Mid-Winter Meeting “PHARMACY: THE CURE FOR ORDINARY”
Educational Grants & Program Sponsors
American Pharmacies
Cardinal Health
Drug Enforcement Administration
New Mexico Board of Pharmacy
New Mexico Pharmaceutical Care Foundation
New Mexico Poison & Drug Information Center
New Mexico Pharmacists Association
The University of Texas at Austin College of Pharmacy
UNM College of Pharmacy
Speaker Information
Joe R. Anderson, PharmD, PhC, BCPS
Associate Professor Pharmacy Practice and School of
Medicine, University of New Mexico, Albuquerque, NM
Amy Bachyrycz, PharmD
Walgreen’s Patient Care Center Clinical Pharmacy
Specialist; Clinical Assistant Professor, UNM College of
Pharmacy, Albuquerque, NM
Krishna J. Chari, Psy.D
Leslie A. McCament-Mann, PhD, RPh
Assistant Professor, New Mexico Poison & Drug
Information Center, UNM College of Pharmacy,
Albuquerque, NM
Cheranne McCracken, PharmD, PhC, BCPS
Drug Inspector, New Mexico State Board of Pharmacy,
Albuquerque, NM
Clinical Psychologist & Assistant Medical Director, Pain
Consultation and Treatment Center, UNMH, Albuquerque
NM
James J. Nawarskas, PharmD, PhC, BCPS
Associate Professor, UNM College of Pharmacy,
Albuquerque, NM
M. Lynn Crismon, PharmD., FCCP, BCPP
Gretchen M. Ray, PharmD, PhC, BCACP, CDE
Dean, James T. Doluisio Regents Chair and Behrens
Centennial Professor, College of Pharmacy,
The University of Texas at Austin, Austin, TX
Associate Professor of Pharmacy Practice; Director PGY2
Ambulatory Care Residencyt UNM College of Pharmacy,
Albuquerque, NM
Ajna Hamidovic, PharmD, MS
Teri Rolan, PharmD, PhC
Assistant Professor of Pharmacy and Psychiatry
University of New Mexico, Albuquerque, NM
Wylie Chemists Compounding Pharmacy, Santa Fe, NM
Shirley J. Scott
Bernadette Jakeman, PharmD, PhC, BCPS, AAHIVP
Assistant Professor, Pharmacy Practice & Administrative
Sciences, UNM College of Pharmacy, Albuquerque, NM
Diversion Investigator, Drug Enforcement Administration,
Albuquerque, NM
Dhara Shah Lari
Ben Kesner, RPh
Executive Director, New Mexico State Board of
Pharmacy, Albuquerque, NM
PharmD Candidate, UNM College of Pharmacy,
Albuquerque, NM
Jennifer Smith, PharmD
Pharmacy Manager, Walgreens, Albuquerque, NM
FULL DISCLOSURE POLICY: All presenters participating in the continuing education programs of the 2016 New Mexico
Pharmacists Association Mid-Winter Meeting are expected to disclose to the program audience any real or apparent conflict(s) of interest
related to the content of his/her presentation. Full disclosure of speaker relationships will be made available at the event. Speakers are
responsible for obtaining proper permission for all images contained in their handout materials which will be posted on the NMPhA
website.
Page 7
NMPhA Mid-Winter Meeting
Hotel Albuquerque at Old Town
NMPhA Mid-Winter Meeting “PHARMACY: THE CURE FOR ORDINARY”
Hotel Reservations
Hotel Albuquerque at Old Town
800 Rio Grande Blvd NW, Albuquerque, NM 87104
(505) 843-6300 / (800) 237-2133
You are responsible for making your own hotel reservations through the Hotel Albuquerque at Old Town.
Make your reservations by Friday, January 8, 2016. After this date reservations will be confirmed
on a space available basis, and at the current rates, which are higher. Room upgrades are available at an
additional charge. If you require handicap access, please advise the hotel of your needs. Remember to
make your reservations early to guarantee the NMPhA Group rate, so PLAN AHEAD!
Single or Double…………………$109.00/day
Room Reservations can be made directly online at…
http://bit.ly/1ijoYrk
 Registration & Program Agenda at www.nmpharmacy.org
Mark Your Calendars…
87th Annual Convention - 6/24/16 – 6/26/16
NMPhA Mid-Winter Meeting
Page 8
Hotel Albuquerque at Old Town
NMPhA Mid-Winter Meeting “PHARMACY: THE CURE FOR ORDINARY”
Name: (Print Clearly) ___________________________
_______ Profession: (R.Ph., CPhT, etc.)_________
NABP e-Profile ID:_________________DOB (MMDD)__________Employer :________________________
(www.MyCPEmonitor.net to obtain ID # - MUST HAVE TO RECEIVE CE CREDIT!)
Address: __________________________________________________________________________________
(How you wish to be listed in NMPhA database)
City: _____________________________________________________ State: _____ Zip: _________________
Work #: __________________ Other #: __________________ E-Mail: _______________________________
Spouse/Guest-Full Name_____________________________________Professional Designation___________
FULL REGISTRATION (1/23 – 1/24/16) — Section A
Daily Registration
Includes 10 contact hrs. + continental breakfast and lunch on 1/24/16.
*=NMPhA membership dues for FULL Registration
Please Circle Choice(s)
Circle which day. Includes continental breakfast and lunch on 1/24/16 only.
Saturday 1/23/16 (4.0 CE)
or
Sunday 1/24/16 (6.0 CE)
Member RPh (10.0 CE)
CNP, CNM, PA (10.0 CE)
*Non-Member RPh (10.0 CE)
Pharmacy Technician (10.0 CE)
*Non-Member Technician
Associate Member/Spouse/Guest (No CE)
COP Students
Saturday Law Program Only (2.0 CE)
$ 300.00
$ 300.00
$ 520.00
$ 170.00
$ 230.00
$ 60.00
FREE
$140
$140
$360
$ 80
$140
$ 0
FREE
$ 50.00
$ 250.00
$ 250.00
$ 470.00
$ 120.00
$ 180.00
$ 60.00
FREE
Section B
Extra Meal Reservations
Per Extra Person (Guest, Spouse & Children)
Saturday, January 23, 2016
Councilor
$25.00 x _____
Lunch
Celebration
$25.00 x _____
Social Hour
Sunday, January 24, 2016
= $________ Sunday Luncheon $30.00 x _____
= $________ **CONTACT NMPhA W/ ANY DIETARY RESTRICTIONS
□ Vegetarian
Payment
Make check out to: NMPhA
Complete this page & mail to:
NMPhA Mid-Winter Meeting
2716 San Pedro NE, Ste. C
Albuquerque, NM 87110
PO registrations,
Fax to: (505) 255-8476
Registration & Payment on-line:
www.nmpharmacy.org
Website: www.nmpharmacy.org
= $________
□ Gluten Free
□ Other___________
Amount Due
Registration Fees (Section A)
Extra Meal Tickets (Section B)
Late Fee after January 18, 2016 add $15.00
$________
$________
$________
**NOTE ANY DIETARY RESTRICTIONS…
Total Due
Payment:  Check  Credit Card  PO
_______
$________
 Cash
VISA/MC/Amex/Discover/DinersClub/PO#
__________________________________________________ Exp Date____
Security Code____________
Billing Address:____________________________________
Name on card______________________Signature_____________________
*Consider joining NMPhA!
Refund Policy: Up to five days prior to the program a refund less a $25.00 administration fee may be obtained.
No refunds after January 18, 2016. Refunds will not be granted for no shows.
Questions: Call (800) 464-8729 or (505) 265-8729
Fax Registrations: (505) 255-8476
NMPhA Mid-Winter Meeting
Page 9
Hotel Albuquerque at Old Town