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 2017-18 Pharmacist Membership Form. If you have purchased Student Liability Insurance through PANL, you will need to upgrade to Regular Liability Coverage, using the 2017-18 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.

2017-18 - Deadline is June 16, 2017

2017-18 Liability Insurance Coverage

2017-18 Student Liability Form

2017 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.

2017-18

2017-18 Pharmacist Membership Form

2017-18 Pharmacy Membership Form

2017-18 Pharmacy Student Membership

2017-18 Associate Membership Form

Other

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Change of Information Form