Appendix I outstanding ipsf activity award report form

Please describe the extent of your chapter’s participation in International Pharmaceutical Students’ Federation (IPSF) activities (see below). In your report, include how your chapter’s IPSF activities demonstrated the following:

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  Innovation: how your activities were creative or unique for chapter members and the community, including any unique IPSF projects separate from standard APhA-ASP programs
  
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  Involvement: how your members were involved in the implementation of your activities with a specific focus on the promotion of international meetings, promotion strategies to members and the public, member training, and overall level of collaboration
  
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  Impact: how your activities affected your chapter, the American community, the profession of pharmacy, and the international community
  

As a reminder official IPSF activities include: Tobacco Awareness, HIV/AIDS Awareness, Healthy Living and Diabetes, Tuberculosis Awareness, Humanitarian Campaign (i.e. Vampire Cup, Pharmabridge), Student Exchange Program (SEP), World Congress, Pan-American Regional Symposia (PARS), etc.

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  Reports may not exceed 1000 words. If your report exceeds 1000 words, only the first 1000 will be submitted to the APhA-ASP Awards Standing Committee. (Include word count at the end of the report.)
  
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  Files must be submitted as a PDF and labeled as “Chapter Name IPSF Report.pdf”.
  

In addition to the essay please complete the Executive Summary at the end of report and submit it along with your report.

No more than five (5) photographs may be submitted with the report. Photographs must be submitted electronically through the Dropbox folder and must be labeled “Chapter Name IPSF Pic #.jpg” (i.e. “U Arizona IPSF Pic 1.jpg” or “SDSU IPSF Pic 2.jpg”). Once photographs have been submitted electronically to APhA, the Association reserves the right to use these photographs in APhA publications, marketing materials, and during APhA meetings.

Additional supporting materials developed by your chapter (original documents/materials only) may be included to illustrate the activities described in your essay. All supporting materials must be scanned and submitted electronically to APhA as a PDF. No more than five (5) documents will be accepted. Files must be labeled “Chapter Name IPSF SM #.pdf” (i.e. “U Arizona IPSF SM 1.pdf” or “SDSU IPSF SM 4.pdf”).

No more than two (2) videos may be submitted with the report. Due to the large size of video files, the Awards Standing Committee will only accept the URL, title, and 35 word synopsis of the video on the official APhA-ASP Video Submission Form. APhA Student Development Staff may request the original file. Once videos have been submitted electronically to APhA, the Association reserves the right to use or link these videos in APhA resources, marketing, and during APhA meetings.

In addition to the essay, please complete the following Executive Summary based on your APhA-ASP Chapter’s IPSF activity and submit it along with your final report.

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  HIV/AIDS Awareness
  
  • 
    Number of events held: ___________________________________
    
  • 
    Number of student pharmacists participants: ___________________________________
    
  • 
    Number of individuals screened: ___________________________________
    
  • 
    Number of individuals educated: ___________________________________
    
    
    
• 
  Healthy Living and Diabetes
  
  • 
    Number of events held: ___________________________________
    
  • 
    Number of student pharmacists involved: ___________________________________
    
  • 
    Number of patients screened: ___________________________________
    
  • 
    Number of individuals educated: ___________________________________
    
    
    
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  World No Tobacco Day:
  
  • 
    Number of events held: ___________________________________
    
  • 
    Number of student pharmacists participants: ___________________________________
    
  • 
    Number of patients screened: ___________________________________
    
  • 
    Number patients educated: ___________________________________
    
    
    
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  Pharmabridge
  
  • 
    Number of books or dollars raised: ___________________________________
    
  • 
    Number of countries books delivered to: ___________________________________
    
  • 
    Number of student pharmacists participants: ___________________________________
    

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  Vampire Cup
  
  • 
    Number of events held: ___________________________________
    
  • 
    Numbers of blood units collected: ___________________________________
    
  • 
    Number of donors: ___________________________________
    
  • 
    Number of individuals educated on blood donation: ________________________________
    
  • 
    Number of student pharmacists participants: ___________________________________
    
  • 
    Number of blood units collected during Live Vampire Cup (June 13-20, 2014): ___________________________________
    

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  Other IPSF Events (IPSF sponsored/non-sponsored):
  
  • 
    Number of events held: ___________________________________
    
  • 
    Number of student pharmacists participants: ___________________________________
    
  • 
    Number of individuals screened: ___________________________________
    
  • 
    Number of individuals educated: ___________________________________
    
    
    
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  Student Exchange Program (SEP)
  
  • 
    Number of members applied for SEP ___________________________________
    
  • 
    Number of members placed for SEP ___________________________________
    
  • 
    Number of students hosted through SEP ___________________________________
    
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  IPSF Meetings
  
  • 
    Number of students who attended World Congress _________________________________
    
  • 
    Number of students who attended other IPSF-affiliated conference ___________________­­­_
    
    
    

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  Please indicate if your chapter participated in these additional IPSF:
  
  • 
    Anti-counterfeit Drug Campaign ___________________________________
    
  • 
    Medicine Awareness Campaign ___________________________________
    
  • 
    World TB Day ___________________________________
    

Please indicate which of the following documents have been uploaded to your Chapter’s Dropbox folder as part of the Outstanding IPSF Activity Award Report.

_____ Executive Summary

_____ Photographs (Number: ___)

_____ Supporting Materials (Number: ___)

“As the Chapter Advisor, I hereby state that the following Outstanding IPSF Activity Award report submission and related materials are the work of our Chapter’s Members and the activities represented in this entry are an accurate portrayal of the work our Chapter has completed.”

APhA-ASP Chapter Name: ___________________________________________________________________

Signature of Chapter Advisor: _____________________________________ Date: _____________________