TSHP ad hoc PAI Committee Application

The ad hoc TSHP Pharmacy Advancement Initiative (PAI) Committee was formerly the ad hoc TSHP Pharmacy Practice Model Initiative (PPMI) Committee.

Thank you for your interest in serving on the TSHP Pharmacy Advancement Initiative (PAI) Committee! To get started, please complete the form below.

* = Required Field
YOUR NAME:*
First Last
YOUR EMAIL ADDRESS:*
YOUR PHONE NUMBER:*
PHONE NUMBER TYPE:*
The phone number listed above is your...
- Cell Phone
- Home Phone
- Work Phone
YOUR HOME ADDRESS:*
Address Line 1 Address Line 2 City State ZIP Code
YOUR EMPLOYER:*
Please enter N/A if you are not currently employed.
YOUR EMPLOYER'S ADDRESS:
Address Line 1 Address Line 2 City State ZIP Code
YOUR SOCIETY MEMBERSHIP(S):*

Current TPA members who hold membership in the Tennessee Society of Health-System Pharmacists (TSHP) are eligible to serve on TSHP committees. TSHP members may submit applications to serve on both TPA and TSHP committees. Applicants must be current on their membership when they apply and throughout the committee term, if selected.
- Tennessee Society of Health-System Pharmacists (TSHP)
- Tennessee Compounding Pharmacists Society (TCPS)
- Tennessee Society of Chain Pharmacists (TSCP)
- Tennessee Society of Independent Pharmacists (TSIP)
- Tennessee Society of Long-Term Care Pharmacists (TSLTCP)
- Tennessee Society of Pharmacists (TSP)
ADDITIONAL COMMENTS:

Please use the space below to provide additional comments, if desired.