2027 BPS Ambassador Application Please complete and submit this form to BPS by Friday, June 12, 2026. Question Title * Please provide your name and contact information. Name * City * State/Province Country * Email Address * Question Title * Employer name Question Title * Job title Question Title * Please describe your current practice/position in 200 words or less. Question Title * Please select the BPS credentials you hold. Select all that apply. Ambulatory Care Pharmacy (BCACP) Cardiology Pharmacy (BCCP) Critical Care Pharmacy (BCCCP) Compounded Sterile Preparations Pharmacy (BCSCP) Emergency Medicine Pharmacy (BCEMP) Geriatric Pharmacy (BCGP) Infectious Diseases Pharmacy (BCIDP) Nuclear Pharmacy (BCNP) Nutrition Support Pharmacy (BCNSP) Oncology Pharmacy (BCOP) Pain Management Pharmacy (BCPMP) Pediatric Pharmacy (BCPPS) Psychiatric Pharmacy (BCPP) Pharmacotherapy (BCPS) Solid Organ Transplantation Pharmacy (BCTXP) Question Title * Please list any membership(s) you have in pharmacy or scientific organizations/associations. Question Title * Please briefly describe any officer or leadership position you have held in pharmacy or scientific organizations/associations, indicating the start and end date. Question Title * Please list the most relevant (up to a maximum of five) professional recognition or awards (e.g., institutional awards, professional organization awards, employer recognition) you have received. BPS Privacy Disclaimer: This application is published and managed by the Board of Pharmacy Specialties (BPS). Please be aware that we take your concerns about privacy seriously and we make every reasonable effort to respect it. Click here to review our Privacy Policy and Terms of Use. Next
