NOMINATION FORM: 2027 APC Board of Directors

NOMINATION FORM: 2027 APC Board of Directors

APC needs you!
The nomination period for the APC 2027 Board of Directors will open July 29, 2026.

To nominate yourself as a potential candidate to the 2026 Nominating Committee for the 2027 APC Board of Directors term, simply complete this form by 11:59 pm Monday, August 17, 2026.

Following approval of the slate by the APC Board, ballots will be available to APC members on Wednesday, September 30, 2026.

If you are not familiar wtih the requirements of the board please go to A4PC.org/2027board for those details before filling out this application.

Important dates

July 21, 2026: APC Town Hall for Nominees
July 29, 2026: Open call for nominations
August 17, 2026: Nominations close
September 4, 2026: Report of the Nominating Committee
September 30, 2026: Ballots distributed
October 19, 2026: Balloting closes
November 5, 2026: Elected candidates contacted
November 20, 2026: 2027 Board of Directors announced to membership
January 1, 2027: Terms start for new board members
WHAT DISTRICT ARE YOU IN?
Name

First NameLast NameTitle (RPh, CPhT, etc.)
Pharmacy or employer name
Home address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Work phone number

Area CodePhone Number
Mobile phone number

Area CodePhone Number
Email
example@example.com
I am a

Other
Professional Service Information
I have served APC for at least one year in the previous three years as...
I have served my state pharmacy association as...
Which state's association was it?
I have served a national pharmacy association as...
Which association?
Application
BOARD POSITION OF INTEREST

Please check one. Current APC individual members and PFM employees are eligible to run only in the district they live in. Students and Corporate Patrons are not eligible to run. Only voting members of the association may run for the board.

Candidates in District III, IV, V, VI, and VII must run in their designated district and are not eligible to run for an At-Large seat. Candidates may only run for the At-Large seat if there is NOT a vacancy in their primary district. There are no At-Large seats available this term.

Each seat is for a three-year term starting January 1, 2027 through December 31, 2029.
I am submitting my name in consideration for the following Board of Directors seat:
NOMINEE STATEMENT: In no more than 100 words, please tell the Nominating Committee and the membership at large why you believe you would be a worthy addition to the APC Board of Directors.

0/100
NOMINEE BIO: In no more than 300 words, please provide the Nominating Committee and the membership at large a short bio about yourself and your career in paragraph form. THIS IS THE TEXT THAT VOTERS WILL READ. Do NOT try to paste your CV!

0/300
HEADSHOT and CV

Please upload the following two files:
1. A current professional headshot (i.e., not a candid personal shot) for use on the electronic ballot. (JPG, PNG, TIF, GIF, EPS)
2. Your latest curriculum vitae (CV) or résumé for use by the APC Nominating Committee. (PDF preferred; .doc, .docx, ODF, RTF, .txt accepted)
Upload your headshot

Click to upload your HEADSHOT here
ONLY use this button for your HEADSHOT Cancelof
Upload your CV or résumé

Click to upload your CV or RESUME here
ONLY use this button for your CV or résumé Cancelof
To be eligible, all materials requested must be provided by the posted deadlines, and the APC membership of the nominee must be current and in good standing.

Please note, that even if you meet the requirements, you are not guaranteed a spot on the final proposal presented to the APC Board of Directors, nor does it guarantee you a spot on the APC Board of Directors.

Please contact APC with questions regarding the nominating process at info@a4pc.org.
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NOMINATION FORM: 2027 APC Board of Directors

Professional Service Information

Application

BOARD POSITION OF INTEREST