2026 FSHP Student Chapter of the Year Application

Please view the point system/rubric on the information page to assist with completing this form.

If your chapter did not participate in an activity, skip it/leave blank.
For the activities your chapter did participate, please include the specific details requested.
If you have conducted more than the number of events in any section, choose your most innovative/impactful events to spotlight.
Only list each event one time.
Points will be verified by the FSHP Professional Affairs Council.

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1. Nominated by
Your Name (Required.)

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2. Your Email Address (Required.)

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3. Your Phone

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4. Student Chapter (Required.)

Florida A&M University (FAMU)

Larkin University (LARKIN)

LECOM Bradenton (LECOM)

Nova Southeastern University (NOVA)

Palm Beach Atlantic University (PBA)

University of Florida (UF) - Gainesville

University of Florida (UF) - Jacksonville

University of Florida (UF) - Orlando

University of South Florida (USF)

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5. Total number of members this academic school year (Required.)

Section A: Individual Member Activities
Indicate below the total number of members who have received State, Regional or National awards or currently hold leadership positions in any organization at this level. A maximum of 30 points can be earned in this section.

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6. Number of members who held a state level office or won a state level award
e.g. Student Poster Winner at FSHP Annual
(3 points per member / do not include FSHP leadership positions, please list those in Section B)

Please list each member's name and position/award that contributed to this score.

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7. Number of members who held a regional level office or won a regional level award
e.g. Regional Student Officer of the South Atlantic Region of Industry Pharmacists Organization
(4 points per member)

Please list each member's name and position/award that contributed to this score.

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8. Number of members who held a national level office or won a national level award
e.g. APhA-ASP National Standing Committee Member, SNPhA National Vice President
(5 points per member)

Please list each member's name and position/award that contributed to this score.

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9. Section A Subtotal (maximum of 30 points accepted) (Required.)

Section B: Membership in FSHP
A maximum of 50 points can be earned in this section.

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10. Percentage of FSHP members to total student body - include all PD years in the count
(<2% = 1 point, 2-5% = 3 points, 6-10% = 5 points, >10% = 10 points / 10 points max)

less than 2%

2-5%

6-10%

more than 10%

Please enter the total number in the student body.

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11. Percent membership increase from previous year
(<2% = 1 point, 2-5% = 3 points, 6-10% = 5 points, >10% = 10 points / 10 points max)

less than 2%

2-5%

6-10%

more than 10%

Please enter the number of members this year AND number of members from the previous year.

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12. Percent of members that attended the last FSHP Annual Meeting
(<2% = 1 point, 2-5% = 3 points, 6-10% = 5 points, >10% = 10 points / 10 points max)

less than 2%

2-5%

6-10%

more than 10%

Please enter the total number of members who attended AND list their names.

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13. Number of members holding FSHP leadership positions - e.g. council members, house of delegates, student director - does not include chapter positions
(1 = 1 point, 2-3 = 5 points, 4+ = 10 points / 10 points max)

2-3

4 or more

Please list their names and position/component.

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14. Number of members holding ASHP leadership positions - e.g. council members, house of delegates, student director - does not include chapter positions
(1 = 1 point, 2-3 = 5 points, 4+ = 10 points / 10 points max)

2-3

4 or more

Please list their names and position/component.

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15. Section B Subtotal (maximum of 50 points) (Required.)

Section C: Chapter Events
List events that you feel are most creative, innovative, and impactful. A maximum of 55 points can be earned in this section.

DEFINITION OF COLLABORATION WITH FSHP LEADERSHIP: A Student Chapter event that involves a pharmacist who is a FSHP active member. The pharmacist may serve as a speaker, coordinator, volunteer, etc.

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16. Event #1 featuring health system speakers
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

Event date:

Speaker name, credentials and position/title:

Brief event description (50-100 words):

Collaboration with FSHP leadership (yes/no):

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17. Event #2 featuring health system speakers
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

Event date:

Speaker name, credentials and position/title:

Brief event description (50-100 words):

Collaboration with FSHP leadership (yes/no):

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18. Event #3 featuring health system speakers
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

Event date:

Speaker name, credentials and position/title:

Brief event description (50-100 words):

Collaboration with FSHP leadership (yes/no):

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19. Event #4 featuring health system speakers
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

Event date:

Speaker name, credentials and position/title:

Brief event description (50-100 words):

Collaboration with FSHP leadership (yes/no):

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20. Residency training information session
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

Event date:

Speaker name, credentials and position/title:

Brief event description (50-100 words):

Collaboration with FSHP leadership (yes/no):

List activities planned by your Chapter where members actively participate to serve patients or the community.

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21. Chapter Service Activity #1
(2 points)

Event date:

Number of volunteers:

Brief event description (50-100 words):

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22. Chapter Service Activity #2
(2 points)

Event date:

Number of volunteers:

Brief event description (50-100 words):

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23. Chapter Service Activity #3
(2 points)

Event date:

Number of volunteers:

Brief event description (50-100 words):

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24. Chapter Service Activity #4
(2 points)

Event date:

Number of volunteers:

Brief event description (50-100 words):

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25. Chapter Service Activity #5
(2 points)

Event date:

Number of volunteers:

Brief event description (50-100 words):

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26. PAI Education Event - PAI information: ashpmedia.org/pai
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

Event date:

Speaker name, credentials and position/title:

Brief event description (50-100 words):

Related PAI Recommendation (see PAI recommendations on ashp.org):

Collaboration with FSHP leadership (yes/no):

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27. Professional or Leadership Development Event: List an activity planned by your Chapter to develop the leadership or professional skills of the student body
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

Event date:

Speaker name, credentials and position/title:

Brief event description (50-100 words):

Collaboration with FSHP leadership (yes/no):

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28. Innovative Project - Definition: Innovative project not covered by other categories
(6 points)

Project title:

Related goals:

Brief event description (50-100 words):

List any events or activities planned to raise awareness or funds for the Political Action Committee, Legislative Days or policy

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29. Policy/Legislative Event #1
(2 points)

Event Date:

Brief event description (50-100 words):

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30. Policy/Legislative Event #2
(2 points)

Event Date:

Brief event description (50-100 words):

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31. Section C Subtotal (maximum of 55 points) (Required.)

Section D: Donations
A maximum of 3 points can be earned in this section. Please make checks payable to FSHP Research and Education Foundation and mail checks to: FSHP - 2910 Kerry Forest Pkwy D4 Suite 376, Tallahassee, FL 32309

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32. Donations to the Research and Education Foundation
($1-250 = 1point, $251-500 = 3 points, $5001+ = 5 points)

$1 - $250

$251 - $500

$501 or more

Amount donated?

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33. Section D Subtotal (maximum of 5 points) (Required.)

Section E: Rubric Feedback
A maximum of 3 points can be earned in this section.

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34. Student Chapter Feedback
(1 point per suggestion)

Suggestion 1:

Suggestion 2:

Suggestion 3:

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35. Section E Subtotal (maximum of 3 points) (Required.)

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36. TOTAL POINTS EARNED - calculate the total number of points earned in all the above sections (maximum of 143 points) (Required.)

Student Chapter Photos
Please attach 1-2 photos that represent your Student Chapter below

2026 FSHP Student Chapter of the Year Application

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* 1. Nominated byYour Name (Required.)

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* 2. Your Email Address (Required.)

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* 3. Your Phone

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* 4. Student Chapter (Required.)

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* 5. Total number of members this academic school year (Required.)

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* 6. Number of members who held a state level office or won a state level award e.g. Student Poster Winner at FSHP Annual(3 points per member / do not include FSHP leadership positions, please list those in Section B)

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* 7. Number of members who held a regional level office or won a regional level awarde.g. Regional Student Officer of the South Atlantic Region of Industry Pharmacists Organization(4 points per member)

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* 8. Number of members who held a national level office or won a national level awarde.g. APhA-ASP National Standing Committee Member, SNPhA National Vice President(5 points per member)

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* 9. Section A Subtotal (maximum of 30 points accepted) (Required.)

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* 10. Percentage of FSHP members to total student body - include all PD years in the count(<2% = 1 point, 2-5% = 3 points, 6-10% = 5 points, >10% = 10 points / 10 points max)

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* 11. Percent membership increase from previous year(<2% = 1 point, 2-5% = 3 points, 6-10% = 5 points, >10% = 10 points / 10 points max)

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* 12. Percent of members that attended the last FSHP Annual Meeting(<2% = 1 point, 2-5% = 3 points, 6-10% = 5 points, >10% = 10 points / 10 points max)

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* 13. Number of members holding FSHP leadership positions - e.g. council members, house of delegates, student director - does not include chapter positions(1 = 1 point, 2-3 = 5 points, 4+ = 10 points / 10 points max)

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* 14. Number of members holding ASHP leadership positions - e.g. council members, house of delegates, student director - does not include chapter positions(1 = 1 point, 2-3 = 5 points, 4+ = 10 points / 10 points max)

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* 15. Section B Subtotal (maximum of 50 points) (Required.)

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* 16. Event #1 featuring health system speakers(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

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* 17. Event #2 featuring health system speakers(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

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* 18. Event #3 featuring health system speakers(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

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* 19. Event #4 featuring health system speakers(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

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* 20. Residency training information session(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

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* 21. Chapter Service Activity #1(2 points)

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* 22. Chapter Service Activity #2(2 points)

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* 23. Chapter Service Activity #3(2 points)

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* 24. Chapter Service Activity #4(2 points)

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* 25. Chapter Service Activity #5(2 points)

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* 26. PAI Education Event - PAI information: ashpmedia.org/pai(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

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* 27. Professional or Leadership Development Event: List an activity planned by your Chapter to develop the leadership or professional skills of the student body (4 points if no collaboration with FSHP leadership, 5 points if collaborated)

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* 28. Innovative Project - Definition: Innovative project not covered by other categories(6 points)

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* 29. Policy/Legislative Event #1(2 points)

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* 30. Policy/Legislative Event #2(2 points)

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* 31. Section C Subtotal (maximum of 55 points) (Required.)

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* 32. Donations to the Research and Education Foundation ($1-250 = 1point, $251-500 = 3 points, $5001+ = 5 points)

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* 33. Section D Subtotal (maximum of 5 points) (Required.)

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* 34. Student Chapter Feedback(1 point per suggestion)

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* 35. Section E Subtotal (maximum of 3 points) (Required.)

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* 36. TOTAL POINTS EARNED - calculate the total number of points earned in all the above sections (maximum of 143 points) (Required.)

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* 37. Photo 1

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* 38. Photo 2

1. Nominated by
Your Name (Required.)

2. Your Email Address (Required.)

3. Your Phone

4. Student Chapter (Required.)

5. Total number of members this academic school year (Required.)

6. Number of members who held a state level office or won a state level award
e.g. Student Poster Winner at FSHP Annual
(3 points per member / do not include FSHP leadership positions, please list those in Section B)

7. Number of members who held a regional level office or won a regional level award
e.g. Regional Student Officer of the South Atlantic Region of Industry Pharmacists Organization
(4 points per member)

8. Number of members who held a national level office or won a national level award
e.g. APhA-ASP National Standing Committee Member, SNPhA National Vice President
(5 points per member)

9. Section A Subtotal (maximum of 30 points accepted) (Required.)

10. Percentage of FSHP members to total student body - include all PD years in the count
(<2% = 1 point, 2-5% = 3 points, 6-10% = 5 points, >10% = 10 points / 10 points max)

11. Percent membership increase from previous year
(<2% = 1 point, 2-5% = 3 points, 6-10% = 5 points, >10% = 10 points / 10 points max)

12. Percent of members that attended the last FSHP Annual Meeting
(<2% = 1 point, 2-5% = 3 points, 6-10% = 5 points, >10% = 10 points / 10 points max)

13. Number of members holding FSHP leadership positions - e.g. council members, house of delegates, student director - does not include chapter positions
(1 = 1 point, 2-3 = 5 points, 4+ = 10 points / 10 points max)

14. Number of members holding ASHP leadership positions - e.g. council members, house of delegates, student director - does not include chapter positions
(1 = 1 point, 2-3 = 5 points, 4+ = 10 points / 10 points max)

15. Section B Subtotal (maximum of 50 points) (Required.)

16. Event #1 featuring health system speakers
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

17. Event #2 featuring health system speakers
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

18. Event #3 featuring health system speakers
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

19. Event #4 featuring health system speakers
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

20. Residency training information session
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

21. Chapter Service Activity #1
(2 points)

22. Chapter Service Activity #2
(2 points)

23. Chapter Service Activity #3
(2 points)

24. Chapter Service Activity #4
(2 points)

25. Chapter Service Activity #5
(2 points)

26. PAI Education Event - PAI information: ashpmedia.org/pai
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

27. Professional or Leadership Development Event: List an activity planned by your Chapter to develop the leadership or professional skills of the student body
(4 points if no collaboration with FSHP leadership, 5 points if collaborated)

28. Innovative Project - Definition: Innovative project not covered by other categories
(6 points)

29. Policy/Legislative Event #1
(2 points)

30. Policy/Legislative Event #2
(2 points)

31. Section C Subtotal (maximum of 55 points) (Required.)

32. Donations to the Research and Education Foundation
($1-250 = 1point, $251-500 = 3 points, $5001+ = 5 points)

33. Section D Subtotal (maximum of 5 points) (Required.)

34. Student Chapter Feedback
(1 point per suggestion)

35. Section E Subtotal (maximum of 3 points) (Required.)

36. TOTAL POINTS EARNED - calculate the total number of points earned in all the above sections (maximum of 143 points) (Required.)

37. Photo 1

38. Photo 2