Pills, Potions and Poisons Teacher Nomination Form | The Ohio State University College of Pharmacy

Please complete the form below to nominate a student for the Pills, Potions and Poisons summer program at The Ohio State University College of Pharmacy.

Please ensure this confirmation email is sent to your work email address. The deadline for submitting your nomination form is April 10, 2026. If you have any additional questions, please feel free to email Dr. Katie Summers at summers.266@osu.edu.

Your Name (person submitting this form)

Your Work Email Address

First name of student you are recommending

Last name of the student you are recommending

In which course(s) do/did you teach the student?

How would you rank the student's performance in your course?

Compared with their peers, please rank this student in the categories below.

Energy and initiative

Intellectual curiosity

Ability to work independently

Oral expression

Written expression

Self-confidence

Classroom participation

Please use the space below to comment further on the nominee’s performance and/or potential. Your opinion regarding how this program may benefit the student is also encouraged and appreciated.

Signatures

The information that has been given in this nomination by the teacher is true and accurate. It reflects the effort of the teacher and not a student or parent/guardian. - Select -

Teacher's Printed Name

Date

Thank you for your help!