Texas Society of Health-System Pharmacists

1. Review Application rules, and submit all documents required

2. Review Criteria for Various Scholarships

3. Complete Online Application or Download Application Form

TSHP Research & Education Foundation
Scholarship Application

scholarship(s) for which you are applying *

Austin Area Society of Health-System Pharmacists Scholarship

Celso and Matiana M. Cuellar Sr. Scholarship

Central Texas Society of Health-System Pharmacist Scholarship

Dr. Michael Piñón-Texas Southern University College of Pharmacy & Health Sciences EPASHP Scholarship

El Paso Society of Health-System Pharmacists Scholarships

Eustacio Galvan Memorial Scholarship

Gene Lake Scholarship

Glenda Lawson McRee Memorial Scholarship

Gulf Coast Society of Health-System Pharmacist Leadership Scholarship

James T. Doluisio Scholarship

Jon Peyton Hudlow Scholarship

Mark Tamble Memorial Scholarship

Metroplex Society of Health-System Pharmacists Scholarship

Michael Patry Texas Tech University School of Pharmacy - EPASHP Memorial Scholarship

Phyllis B. Ginsburg Memorial Scholarship

Robert Leonard Scholarship

Sandra Evans Webb Scholarship

STUDENT INFORMATION

First Name *

Middle Name

Last Name *

Race/Ethnic Origin (for applicants for Cuellar or Galvan scholarships:

College of Pharmacy *

Expected Date of Graduation *

Student Mailing Address *

Student Residence Phone

Permanent Address *

City *

State

Zip

Permanent Residence Phone

E-mail Address

EDUCATION, AWARDS, and MEMBERSHIPS
High School *
College Attended	Degree	Dates Attended


G.P.A for pharmacy curriculum *
Organizational Memberships and Leadership Positions Held
Awards and Honors Received (schools and/or organizations)

EMPLOYMENT EXPERIENCE
Non-Pharmacy Related
Employer	Location	Dates Employed	Job Title



Pharmacy Related
Employer	Location	Dates Employed	Job Title



REFERENCES - (Instructor, Employer, or Personal)
Name	Organization/Company/Relationship		Phone Number --
Name	Organization/Company/Relationship		Phone Number --
Name	Organization/Company/Relationship		Phone Number --

Untitled Document

Texas Society of Health-System Pharmacists

3000 Joe DiMaggio #30-A, Round Rock, TX 78665-3994

Phone: (800) 242-8747 / (512) 906-0546 Fax: (512) 852-8514

Email: tshp@tshp.org