Pharmacy Stars Shining Star Compounding Pharmacy Technician
Nominee Information
Nominee Name
*
First Name
Last Name
Nominee Email Address
example@example.com
Nominee Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Is the nominee a pharmacy technician focused in compounding?
*
Yes
No
Please list the nominee credentials or any additional training (ie: CSPT or ASHP certification):
*
How many years has the nominee been a member of OSHP? (if not a member please state 0):
*
Please describe the nominee’s contributions to pharmacy operations or leadership roles within the past 3yr:
*
Please describe the nominee’s contributions to health system pharmacy within the past 3yr:
*
Please describe the nominee’s contributions to medication/patient safety within the past 3yr:
*
Please describe any additional significant work that the nominee has participated in within the past 3yr:
*
Nominator Name
First Name
Last Name
Nominator Email Address
example@example.com
Nominator Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Please upload the nominee’s CV and letter(s) of support:
*
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