Pharmacist of the Year Nomination - Pharmacists' Association

Name of Nominator*

First Last

Email*

Telephone*

Address*

Address City Province Postal Code

Name of Pharmacist

First Last

Work Location

Please upload a letter or outline as to why the candidate should be awarded Pharmacists of the Year*

• Deadline for submissions is Monday, August 3, 2020

• All submissions are kept strictly confidential until award is presented.

Drop files here or

Signature

Phone

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2020 Pharmacist of the Year Award