REMINDERS

To have your video considered, you must complte all the following by 11:59pm PST on December 1, 2024.

1. Upload your video to your own YouTube account.

2. Complete and upload PharmFlix Authorization Video and Release Form.

All rules and regulations can be found here.

Entry Information

APhA-ASP Region *

School or College of Pharmacy *

Video Name: * 🛈

YouTube Link: * 🛈

APhA is not responsible for incorrect URL submissions or inaccurately labeled videos.

Video Length (mm:ss) *

Video Category (select one). * 🛈

Inspirational

Humorous

Other Other

PharmFlix Authorization & Release Forms: *

Scan or create a PDF of all your forms into ONE document.

Music

Please note that purchasing or downloading music does not permit you to use it for your video according to copyright laws. The music for your video must be exempt from copyright law (original work that belongs to you, public domain, or royalty-free) or you must ask permission from the creator of that specific piece of music.

The music in our entry is: *

Please upload documentation of proof.

Contact Information

Your First Name: * 🛈

Your Last Name: * 🛈

Phone: *

E-mail Address *

Confirmation: *

I attest that I have the support of my school/college for this submission.

I attest that the APhA-ASP Chapter Advisor has reviewed and approved the submission.

If requested by APhA, I will provide my video in a .mpg or .mp4 format to be shown at APhA Annual Meeting.

I understand that I will not be notified by APhA before February regarding the the Top 10 finalists for each category.

Signature *

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