Pills, Potions, and Poisons: Teacher Nomination Form

Instructions for the Teacher: Complete the form below to nominate a student for the Pills, Potions and Poisons summer program at The Ohio State University College of Pharmacy. Once you have submitted the nomination form, please email Dr. Cynthia Canan at canan.20@osu.edu to confirm your submission. Please ensure this confirmation email is sent from your work email address. The deadline for submitting your nomination form is April 16, 2021. If you have any additional questions, please feel free to email Dr. Canan.

3. Compared with his/her peers, please rank this student in the categories below.

Ability to work independently
Below Average
Outstanding (top 5% this year)
No basis for judgment



Thank you so much for your help!

Enter the characters shown in the image.