PharmCORP Registration

PharmCORP Registration
Please fill out the form below to register for PharmCORP. This event will be held at Southwestern Oklahoma State University College of Pharmacy in Weatherford, Oklahoma on Saturday, September 26, 2026. The registration deadline is September 11, 2026, at 11:59 pm.

There is a registration fee of $25 which can be paid using Venmo after filling out this form or by check payable to Kappa Epsilon & postmarked on or before the Sept. 11th deadline.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Age
Enter your age.
Grade
Enter your current grade.
School
Enter your school name.
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
List any allergies
Allergies
List any medications
Is the student taking any medications?
Dietary Restrictions Choice Form Element

Other
If other, list
List for "Other" option.
T-shirt Size
Interest in the pharmacy profession (1=lowest, 5=highest)
Parent/Guardian (Emergency Contact)

First NameLast Name
Emergency Contact Email
example@example.com
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Payment Method

The registration fee is $25. You may pay using Venmo (@Kappa-Epsilon-4) or by mailing a check or money order to:

Kappa Epsilon PharmCORP

SWOSU College of Pharmacy

100 Campus Drive

Weatherford, OK 73096
Payment Method
Should be Empty:

Payment Method