Indiana University Bloomington
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Seven Drugs, One State
Indiana Priority Drug Series

(* denotes required field)

• Name: *    
• Organization: *    
• Title: *    
• E-mail: *    
• Phone Number: *   ex) 123-456-7890  
• Fax Number:   ex) 123-456-7890  
• Mailing Address: *    
• City: *    
• State: *    
• Zip: *    
• Please select what date(s) you are attending: *
Note: Prevention professionals across the state have expressed a high need for prescription drug information. Therefore, each afternoon will include the same prescription drug presentation. If you want to attend more than one training, you have the option to decide which afternoon to attend the prescription drug presentation. On the day you do not attend the afternoon portion you will be allowed to leave after a working lunch.
If attending more than one training, please select which date you will attend the afternoon prescription drug portion.
• Payment *  
Cost: One training is $50. Two trainings is $90. All three trainings are a total of $130.

If you have questions, contact Jasynda Lacy at 812-855-3919 or jjlacy@indiana.edu More details will be sent to you as the training date approaches. Please cancel 5 business days before a training to avoid being charged.