2019 Pharmacist of the Year Award

Deadline: May 3rd, 2019

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 Friday, May 3, 2019

• All submissions are kept strictly confidential until award is presented on September 21, 2019
Drop files here or
Signature
Email
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Telephone:

(709) 753-7881

Toll Free:

(866) 753-7881

Fax:

(709) 753-8882

Email:

email@panl.net