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CPHS Student Congress Application Form

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College of Pharmacy and Health Sciences
CPHS Student Congress Application Form

CPHS Student Congress

CPHS Student Congress Application Form
CPHS Student Congress COVID-19 Video

Please complete this form to apply for membership in The Student Congress of the College of Pharmacy and Health Sciences.

Name

First

Last

E-mail

Cell Phone Number

Biomedical Sciences

Sophomore

Junior

Senior

Health Sciences

Physician Assistant

Clinical Laboratory Sciences

Radiologic Sciences

Toxicology

Pharmacy

P1 (Professional year 1)

P2 (Professional Year 2)

P3 (Professional year 3)

P4 (Professional year 4)

Graduate Programs

Pharmacy Administration

Pharmaceutical Sciences Masters

Pharmaceutical Sciences Ph.D.

Physician Assistant

Public Health

Toxicology

Year

Junior

Senior

Provide a brief description highlighting your involvement within the College (student organization e-board or membership, attending College conferences, community service, extracurricular activities, etc.).

Leave this field blank

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Notice of Non-Discrimination, Equal Opportunity

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Admission: 718-990-2000

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St. John’s University does not discriminate on the basis of race, color, national origin, sex, disability, or age in its programs and activities. The Office of Equal Opportunity and Compliance, [email protected], 718-990-2660, has been designated to handle inquiries regarding the non-discrimination policies.