Superintendent Pharmacist of the Year 2020

Superintendent Pharmacist of the Year Award 2020

It is extremely important that all details are correct and all answers are answered.
Guidelines for entry:
- Application forms for awards entries must be received via email by March 20th, 2020.
- Please restrict answers to no more than 350 words, unless otherwise stated.
- Please be aware this is an individual entry.
- Supporting material such as examples of achievements, recommendations, annual reports, graphs, and videos may be included.
Name of Pharmacist entering:

First NameLast Name
Pharmacy name:
Pharmacy address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pharmacy Phone Number:

Area CodePhone Number
Mobile Number:
Email:
example@example.com
Name of person nominating the entrant (If different from above):

First NameLast Name
Pharmacy name:
Pharmacy Phone Number:

Area CodePhone Number
Mobile Number:
Email:
example@example.com
Is the Nominee aware of your nomination?

YesNo
Names of local newspaper and radio stations you would like to see coverage in:
PR & Marketing contacts:
The next section involves 5 questions. Questions 1- 4 must be answered in no more than 350 words, and question 5 in no more than 1,000 words

Supporting material is permitted and is not included towards your word count in answering questions 1-5 above.
Please send a maximum of four high res images to accompany your application. All images must contain full captions.

Deadline: 20th March, 2020
1. Please give details of the public health services and initiatives carried out by this individual over the last 12 months:

0/1000
2. How have they demonstrated engaging with their local community?

0/1000
3. Please outline any challenges they have faced over the last 12 months and/or opportunities they have created:

0/1000
4. Please give evidence on the impact they have had on their pharmacy business and on the community they serve:

0/1000
5. In no more than 1,000 words, please outline below why this person deserves the title of Superintendent Pharmacist of the Year Award 2020:

0/1000
Please upload a high resolution, head and shoulder image of the Superintendent Pharmacist entering/being nominated for this category:

Upload Image
Advise: This image will be used in the IPN Magazine to showcase the finalists. Cancelof
Please attach any additional research or information to further support your application. This will assist the judges in their decision making process:

Browse Files

Cancelof
Should be Empty:

Superintendent Pharmacist of the Year Award 2020