Tennessee Pharmacists Association | TSHP Directors of Pharmacy Committee Application

Thank you for your interest in serving on the TSHP ad hoc Directors of Pharmacy Committee! To get started, please complete the form below.

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YOUR NAME:*

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YOUR EMAIL ADDRESS:*

YOUR PHONE NUMBER:*

PHONE NUMBER TYPE:*

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YOUR HOME ADDRESS:*

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YOUR EMPLOYER:*

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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)

DIRECTOR OF PHARMACY POSITION:*

By submitting this application, I confirm that I am a TPA/TSHP member and the Director of Pharmacy at the following institution. (Please enter N/A If you are not currently in a Director of Pharmacy position.)

ADDITIONAL COMMENTS:

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