This form is for all PSW membership to enter their interest in current PSW committees and groups; and/or interest in creating new group(s) of shared interest. Members are encouraged to use this form for self-nominations or to nominate other PSW members.

One voice, one vision for all. PSW supports diversity in our membership, equity in our opportunities, and inclusiveness in our organization. We embrace our differences, unifying efforts to enhance patient care while advancing our profession. Our patients are diverse, and so are we. 

PSW welcomes nominations of leaders who represent diversity in race, color, ethnicity, culture, national origin, sexual orientation, age, gender, gender identity, social class, physical ability/attributes, religious or ethical value systems, language, pharmacy practice area, geographic location, and other perspective shaping backgrounds.

Question Title

* 1. Applicant Information

Question Title

* 2. Preferred method of contact

Question Title

* 3. Desired Board/Committee/Group (Select 1 or more in order of preference)
Members are asked to serve on one Advisory/Section per term, to allow for all members to have an opportunity to serve and participate. 

Reference the PSW Website for more information about each Advisory/Section

Question Title

* 4. Desired level of involvement

- Advisory Chair-Elect can only be selected by current Advisory Members. 
- Residents currently can serve/volunteer for the Ambulatory Care Advisory Committee (ACAC) or Community Pharmacy Advisory Committee (CPAC)