PHARMACY PRACTICE RESIDENCY AWARD
The purpose of this award is to recognize the two hospital pharmacy residents whose major project are judged
to be the most deserving in terms of representing a significant innovation, practical application and/or
development in an institutional pharmacy practice setting. Any hospital pharmacy resident who is a member of
CSHP (and a member during the residency program), and is enrolled in a CHPRB accredited residency program,
or have completed such a program in the previous year, is eligible. A plaque, a cash award of $1000, and an
engraved Inuksuk will be awarded to each award winner. Detailed descriptions and eligibility criteria are
available on the BC CSHP website. Please submit this form with your application package as an e-mail
attachment to CSHP BC Awards Chair: bccshpaward@gmail.com
Award Applicant Information
Name of Applicant ______________________________________ CSHP Membership #:____________
Residency Program:___________________________________________________________________
E-mail: _____________________________________________ Phone #: (____) __________________
Project/Paper Title:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
If submission has other authors who are CSHP members, please fill in the information
below:
Other Author Information
Name _________________________________________ CSHP Membership #:___________________
Current Place of Employment: _____________________________ Position: _____________________
E-mail: ___________________________________________ Phone #: (____) ____________________
Other Author Information
Name_______________________________________________ CSHP Membership #:______________
Current Place of Employment: ______________________________Position: _____________________
E-mail: ____________________________________________ Phone #: (____) ____________________
Signature of Applicant: ___________________________________ Date: __________________________
Deadline: August 31st