PANL Forms

To Fourth Year Students registering as Pharmacists

Please note that once you receive your PEBC results, you will need to fill out the 2018-19 Pharmacist Membership Form. If you have purchased Student Liability Insurance through PANL, you will need to upgrade to Regular Liability Coverage, using the 2018-19 Student Liability Insurance Upgrade from Student/Intern to Pharmacist. If you have any questions or require further clarification, please contact the PANL office at email@panl.net or 709-753-7881.

Insurance

Please ensure you submit the correct form. A processing fee will be charged for refunds.

2018-19

Liability Insurance Coverage

Student Liability Coverage

Liability Insurance Coverage | Upgrade from Student/Intern Only

Membership Application / Renewal

Please ensure you submit the correct form. A processing fee will be charged for refunds.

2018-19

Pharmacist Membership Form

Pharmacy Membership Form

Pharmacy Student Membership

Associate Membership Form

Other

Advertising With PANL

Relief Pharmacist Registration

Change of Information Form