PANL Membership Forms 2021-22
To Fourth Year Students registering as Pharmacists
Please note that once you receive your PEBC results, you will require to fill out the 2021-22 Pharmacist Membership Form(New Pharmacist). If you have purchased Student Liability Insurance through PANL, you will require to upgrade to Professional Liability Coverage, using the 2020-21 Student Liability Insurance Upgrade from Student/Intern to Pharmacist prior to July 1, 2021.
If you are registering as an Intern please complete the regular Pharmacist Membership stating 'Intern' in the license number section. Once completed you can avail of the Student/Intern Liability Insurance.
If you have any questions or require further clarification, please contact the PANL office at email@example.com or 709-753-7881.
Membership Application / Renewal
Please ensure you submit the correct form. A $15.00 processing fee will be charged for refunds.
2021-22 | Valid April 1, 2021-March 31, 2022