PANL Forms

To Fourth Year Students registering as Pharmacists

Please note that once you receive your PEBC results, you will require to fill out the 2019-20 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 2019-20 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 - Policy Begins July 1, 2019 - July 1, 2020

Please ensure you submit the correct form. A $25.00 processing fee will be charged for refunds. 

2019-2020 

Membership Application / Renewal 

Please ensure you submit the correct form.  A $25.00 processing fee will be charged for refunds. 

2019-20 | Valid April 1, 2019-March 31, 2020

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