SITE VISIT REQUEST FORM
This form is to be completed in its entirety in order to request that a member or members of the PLS Board of Directors visit your chapter. Site visits are a major priority for the PLS Board of Directors, with the goal of enhancing outreach to both growing and well-established PLS chapters throughout the country. We hope to learn more about what your chapter does well, and also learn how we can better serve your individual chapters. The Board members would be interested in meeting your Dean, student affairs representative, other administrators, chapter advisors, and alumni. The site visit can be individualized to the needs of your chapter, campus, site, etc. Below are some of the potential activities that our executive member can lead and/or participate in:

Meeting with administration – Board member(s) can meet with administration at your college or school to further discuss the student leadership development needs at your institution

Leadership presentation – Board member(s) can provide a presentation on leadership, how to succeed in pharmacy school, etc. We are open to re-using current materials or creating new materials based on the interests of your chapter

Induction ceremonies & general membership meetings – Board member(s) can speak and/or observe meetings or events of your chapter, including speaking at annual induction ceremonies. We recognize that each chapter has exceptional individuals within it, and hosts a number of exciting events to recognize and/or utilize those individuals. We would be honored to participate in these events

Please Note: Site visit requests must be submitted at least 4 weeks prior to the earliest requested visit date. When this form is submitted, requests will be honored in the order that they are received based on the availability of the executive committee members

**Due to COVID-19, all Chapter Outreach opportunities have been moved to virtual Zoom calls.**
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Email *
School Name *
Chapter Name: *
Chapter Advisor *
Chapter Advisor Email *
If applicable, when was your last site visit? (If not applicable, put N/A) *
Chapter Contact Name: (who is submitting this form) *
Chapter Contact Number: *
Chapter Contact Email Address: *
On average, how many events does your chapter hold annually? *
Did your chapter attend the 2023 House of Delegates? *
Type of Visit Requested
The site visit can be individualized to the needs of your chapter, campus, site, etc. Below are some of the potential activities that our executive member can lead and/or participate in:

Meeting with administration – Board member(s) can meet with administration at your college or school to further discuss the student leadership development needs at your institution

Leadership presentation – Board member(s) can provide a presentation on leadership, how to succeed in pharmacy school, etc. We are open to re-using current materials or creating new materials based on the interests of your chapter

Induction ceremonies & general membership meetings – Board member(s) can speak and/or observe meetings or events of your chapter, including speaking at annual induction ceremonies. We recognize that each chapter has exceptional individuals within it, and hosts a number of exciting events to recognize and/or utilize those individuals. We would be honored to participate in these events.
What are the dates that you are requesting a visit from the Board of Directors? (MM-DD-YYYY - MM-DD-YYYY format) **If you are requesting a visit for a specific event, please include the time (and timezone) for that event.** *
Which type of visit are you requesting? *
Describe your reason for requesting a site visit? *
I acknowledge that all site visits will be conducted virtually. *
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A copy of your responses will be emailed to the address you provided.
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