Welcome to the Desire to Serve Committee Appointment Form

By completing and submitting this form, you are indicating your desire to be appointed to a committee within the California Pharmacists Association (CPhA). You acknowledge that committee appointments are considered and approved by the CPhA Board of Trustees and will go in affect each year after the Annual Business Meeting at the Western Pharmacy Exchange Conference.

First Name *

Last Name *

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Phone *

Email *

Which category describes your membership category within CPhA? *

Other (specify)

Which CPhA Local Chapter(s) are you affiliated with? *

What is your primary practice setting? *

Other (specify)

Select the committee(s) you are seeking appointment for. For a description of our committees click here. *

Awards Committee (3-year term)

Editorial Review Committee (3-year term)

Education Advisory Committee (3-year term)

Elections Committee (3-year term)

Finance & Audit Committee (3-year term)

Insurance Committee (3-year-term)

Investment Committee (3-year-term)

Legislative Committee (3-year-term)

Policy Committee (1-year term)

List your prior appointed and elected positions you have held with CPhA and other pharmacy related associations. *

What other leadership and/or volunteer experience do you have that would be valuable in the position(s) you are seeking? *

Upload all required files including CV/resume (required) and a letter of recommendation (should you desire to provide one).

CV/Resume *

Professional Headshot *

Letter of Recommendation (optional)

If you are slated for appointment, we would like to share your professional biography with the members and the Board of Trustees. As such, provide your professional biography to provide insight into your role as a pharmacy professional. *