Volunteer for a KSHP Committee

Are YOU interested in joining a KSHP Committee? Please share your time and help the Society with your time and talents.



Please complete the Volunteer Form and submit to the KSHP office. Please note your committee preference below. You will only be assigned to ONE committee. However, some committees may be full so in order to help with placement we ask that you list your first, second and third choice.

Your information will be forwarded to the KSHP President for review.

Thank you for your time and if you have any questions regarding this submission form please contact the KSHP office at info@kshp.org.

Please Note: Only KSHP members are able to serve on committees.


I am a current member of KSHP: *
Yes
No

First Name: *

Last Name: *

Address 1:

Address 2:

City:

State:

Zip:

Office Phone:

Mobile Phone:

Fax Number:

Email: *

Committee that is your FIRST choice: *

Committee that is your SECOND choice: *

Committee that is your THIRD choice: *

Category of Membership: *
Pharmacist
Resident
Technician
Pharmacy Student
Technician Student
Other