Under My Wing Mentorship Program-Student Application

The Under My Wing Mentorship Program is designed to connect students and dynamic independent pharmacy owners to explore ownership as a career path; a real world experience where a mentor will take a student under their wing. The focus of this mentorship is in owning/operating independent pharmacy. The Mentorship Program provides the connections between independent pharmacy owners and students, and highlights the importance of being an active member with the National Community Pharmacists Association(NPCA) and/or the Pharmacists Society of the State of New York(PSSNY). More importantly, it helps bridge the gap between potential owners, potential sellers, as well as future employers and employees.

1. Contact Information *This question is required.

First Name

Last Name

Mailing Street Address

City

State

Zip

Email Address

Phone Number

School/College of Pharmacy Name

Student Membership

2. I am interested in pharmacies which focus on: (check all that apply)

3. Other areas of focus not previously mentioned:

4. I am interested in connecting to pharmacists:

to learn all about the business side of pharmacy, and explore ownership as a career path
to partner with pharmacists in holding health and wellness events and programs
to have Mentor as a guest speaker at our school of pharmacy /NCPA student chapter/ PSSNY student chapter meeting
for potential junior partnerships down the road
as a potential purchaser of his/her pharmacy/pharmacies
I would prefer to be mentored in person

5. Statements of Understanding: please check each box to verify that you have read and comprehended the statements of understanding. *This question is required.

I agree that I am interested in being part of the Under My Wing Mentorship Program in order to receive guidance along with personal and professional development from Mentor pharmacists.
I understand that being matched in the Under My Wing Mentorship Program is a year-long commitment of at least one hour in person, on the phone, or via video call, per month with my Mentor.
I understand that I can choose to renew my one year commitment of my Mentor in the Under My Wing Mentorship Program, or decide to be re-matched for a new year-long commitment.
I understand that being part of the Under My Wing Mentorship Program is a privilege which can be revoked at any time, if I do not comply with the minimum requirements or standards set forth by the Under My Wing Mentorship Program.
I understand that this is not a job interview for future employment.
I understand that the Under My Wing Mentorship Program does not require me to work in the Mentor's pharmacy.

Under My Wing Mentorship Program-Student Application

Under My Wing Mentorship Program- Student Mentee Application