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Association of Black Health-System Pharmacists
2910 Kerry Forest Pkwy., D4-393
Tallahassee, FL 32309
Phone: (888) 834-0603

FAX: (850) 512-1821

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Student Nominee First and Last Name	Invalid Input
Evaluated by	Invalid email address.
Evaluator Email	Invalid Input
	Please rate each candidate using the scale and criteria below: 5 = Strongly Agree 4 = Somewhat Agree 3 = Uncertain 2 = Somewhat Disagree 1 = Strongly Disagree
	OVERALL GPA (Weighted point value = 1)
Candidate has demonstrated high academic achievement	5 = Strongly Agree4 = Somewhat Agree3 = Uncertain2 = Somewhat Disagree1 = Strongly Disagree Invalid Input
Candidate has maintained an overall GPA of 3 or higher	5 = Strongly Agree4 = Somewhat Agree3 = Uncertain2 = Somewhat Disagree1 = Strongly Disagree Invalid Input
	PROFESSIONAL AFFILIATIONS (Weighted point value = 2)
Candidate has supported the profession such as through memberhsip and participation in organizations	5 = Strongly Agree4 = Somewhat Agree3 = Uncertain2 = Somewhat Disagree1 = Strongly Disagree Invalid Input
Candidate has been active through membership in COMMUNITY organizations	5 = Strongly Agree4 = Somewhat Agree3 = Uncertain2 = Somewhat Disagree1 = Strongly Disagree Invalid Input
Candidate has served as an elected officer of a student pharmacy organization	5 = Strongly Agree4 = Somewhat Agree3 = Uncertain2 = Somewhat Disagree1 = Strongly Disagree Invalid Input
Candidate has served as a member of a council committee task force or ad hoc group of an institution or pharmacy organization or community organization	5 = Strongly Agree4 = Somewhat Agree3 = Uncertain2 = Somewhat Disagree1 = Strongly Disagree Invalid Input
Check if professional affiliation included ABHP	5 = Strongly Agree Invalid Input
	PHARMACY PRACTICE (Weighted point value = 3)
Candidate has demonstrated an interest in hospital or health system pharmacy practice	5 = Strongly Agree4 = Somewhat Agree3 = Uncertain2 = Somewhat Disagree1 = Strongly Disagree Invalid Input
Candidate has participated in special study or research projects related to pharmacy practice	5 = Strongly Agree4 = Somewhat Agree3 = Uncertain2 = Somewhat Disagree1 = Strongly Disagree Invalid Input
Check if participation in pharmacy practice activities has been associated with ABHP involvement	5 = Strongly Agree Invalid Input
	PROFESSIONAL AND COMMUNITY SERVICE (Weighted point value = 4)
Candidate has demonstrated involvement in community or professional service	5 = Strongly Agree4 = Somewhat Agree3 = Uncertain2 = Somewhat Disagree1 = Strongly Disagree Invalid Input
Candidate has participated in high school career day programs or health education or drug abuse programs	5 = Strongly Agree4 = Somewhat Agree3 = Uncertain2 = Somewhat Disagree1 = Strongly Disagree Invalid Input
Candidate has participated in community volunteer programs	5 = Strongly Agree4 = Somewhat Agree3 = Uncertain2 = Somewhat Disagree1 = Strongly Disagree Invalid Input	Examples include Big Brother or Big Sister etc
Check if participation in service activities has been associated with ABHP involvement	5 = Strongly Agree Invalid Input
FINISH