PANL Applications & Forms
If you have any questions or require further clarification, please contact the PANL office.
Please ensure you submit the correct form. A $15.00 processing fee will be charged for refunds.
Membership Applications
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Membership Forms
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2023-24
2023-24 Member Applications & Renewals
Valid April 1, 2023 - March 31, 2024
To Fourth Year Students registering as Pharmacists
Please note that once you receive your PEBC results, you will require to fill out the 2023-24 Pharmacist Membership Form. If you have purchased 2023-2024 Student Liability Insurance through PANL, you will require to upgrade to Professional Liability Coverage, using the 2023-24 Student Liability Insurance Upgrade from Student/Intern to Pharmacist .
If you are registering as an Intern please complete the regular 2023-2024 Pharmacist/Intern Membership stating 'Intern' in the license number section. Once completed you can avail of the Student/Intern Liability Insurance.
Liability Insurance Applications
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Liability Forms
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2023-24
2023-24 Liability Insurance
Valid July 1, 2023 - July 1, 2024
To Fourth Year Students registering as Pharmacists
Please note that once you receive your PEBC results, you will require to fill out the 2023-24 Pharmacist Membership Form (New Pharmacist). If you have already purchased 2023-24 Student Liability Insurance through PANL, you will require to upgrade to Professional Liability Coverage. Please call our office for more information to upgrade.
If you have any questions or require further clarification, please contact the PANL office at email@panl.net or 709-753-7881.
Other Forms
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Other forms
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Relief Registration
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Advertising
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Award Nominations
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General