Membership Profile Form

Name *

First

Last

Preferred Name

Address *

Address Line 1

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City

State

Zip Code

Phone Number *

How community?

Email Address *

LinkedIn Profile URL *

Website

Preferred Time Zone *

Professional Background Area(s) of Expertise (check all that apply) *

Other Professional Background Area *

Years of Experience in the Pharma/Biotech Industry *

Years of Experience Consulting in the Pharma/Biotech Industry *

List of Therapeutic Areas You’ve Worked In

Brief Professional Bio (2–3 sentences): *

Upload Your CV or Resume (only .doc, .docx, or .pdf files accepted) *

Drag & Drop Files, Choose Files to Upload

Why are you interested in joining SOPPhC? *

What do you hope to gain from membership? *

What skills, experience, or perspectives can you contribute to the SOPPhC community? *

Are you interested in volunteering on committees, working groups, or special projects (strongly encouraged)? If yes, please describe

Do you agree to uphold SOPPhC’s values of integrity, collaboration, innovation, excellence, and inclusion? *

Do you have any conflicts of interest we should be aware of? If yes, please describe: *

Would you like to be listed in the SOPPhC Member Directory? *

Do you have articles, publications, or speaking engagements we can highlight? If yes, please link:

Are you open to speaking opportunities, publications, or mentorship within the SOPPhC community? *

How did you hear about SOPPhC?

Additional Notes or Questions:

Privacy *

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