Albert E. Rosica, Jr. Memorial Award Nomination

Presented to a pharmacy practitioner in recognition of exemplary service to pharmacy students and fulfilling other responsibilities in pharmacy education.

The Albert E. Rosica, Jr. Memorial Award is presented to a pharmacy practitioner in recognition of exemplary service to pharmacy students and fulfilling other responsibilities in pharmacy education. All colleges of pharmacy are requested to nominate one candidate. As a part of the award, a $1,000 contribution will be made to the College of Pharmacy of the award recipient’s choice to be used to assist a pharmacy student to complete his or her education.

Criteria for the Albert E. Rosica, Jr. Memorial Award

Service on college committees, e.g. admissions or curriculum
Participate in alumni activities
a. Officer
b. Committee member
c. Fund raiser
Serve as instructor
a. Teach courses
b. Lecture in courses
c. Serve as preceptor
Recommendations from faculty and students

Click here for a list of the past Albert E. Rosica, Jr. Memorial Award Recipients.

Albert E. Rosica, Jr. Memorial Award Nomination Form

"*" indicates required fields

Name of Nominee*

First Middle Last

Present position and title:*

Education

School or College of Pharmacy*

Address*

City State / Province / Region

Degree*

Year*

Also licensed by (States)*

Please complete the following information which will be used in determining the recipient of this year’s award and attach any additional information you feel should be considered by the selection committee.

Service on college committees, e.g. Admissions or Curriculum:*

Participation in alumni activities, e.g. officer, committee member, or other major service functions:*

Service as instructor, e.g. teaching courses, serving as lecturer, serving as preceptor, or other teaching responsibilities:*

Office(s) held in local, state, or national pharmacy associations:*

Office

Association

Year

Honors and awards received:*

Date of birth:*

Preferred mailing address:*

Home

Business

Home Address*

Street Address City State ZIP Code

Home Telephone*

Business Address*

Street Address Address Line 2 City State ZIP Code

Business Telephone*

Submitted by:

Name

First Last

Date

Additional Information for the Selection Committee:

Example - Recommendations from faculty and students.

Accepted file types: doc, docx, pdf, jpg, png, Max. file size: 1 GB.

Additional Information for the Selection Committee:

Example - Recommendations from faculty and students.

Accepted file types: doc, docx, pdf, jpg, png, Max. file size: 1 GB.

Additional Information for the Selection Committee:

Example - Recommendations from faculty and students.

Accepted file types: doc, docx, pdf, jpg, png, Max. file size: 1 GB.

Additional Information for the Selection Committee:

Example - Recommendations from faculty and students.

Accepted file types: doc, docx, pdf, jpg, png, Max. file size: 1 GB.

Name

This field is for validation purposes and should be left unchanged.