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American Family Children's Hospital
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Applying to the Pharmacy Technician Training Program as a Student

Please fill out the following form if you are applying to the UW Health Pharmacy Technician Training Program as a student. There is a separate form to fill out if you wish to apply as a new or current UW Health employee. If both applications apply, you may fill out both applications. 

 

Apply as a Student

 

Individuals who prefer to pay tuition with no commitment to work for UW Health, please fill out the application below. If the field is required and does not apply to you, please enter "NA."

 

What is the cost of the program if I am accepted into the program via the student route?

 

The cost of the program is $3,400. This fee is all-inclusive, though additional parking fees may apply during experiential training. Tuition includes the following:

  • Required textbooks
  • All lab fees, equipment, materials and resources
  • Scrubs (for experiential hours in our sterile products area)
  • One-time PTCB (Pharmacy Technician Certification Board) exam fee
  • CPR Certification
  • One free year membership to the Pharmacy Society of Wisconsin (PSW)
  • Metro bus pass - valid for duration of program 

What are my payment options? 

  • A $400 down payment is required upon acceptance to the program. The $400 payment will be applied to the $3400 tuition. Payment can be paid in full prior to the start of the program or $1,000 payments due on weeks 4, 8 and 12 must be worked out upon acceptance into the program. We accept cash or check only. 

If you have any questions after applying for a student position, please call (608) 890-8057.

 

STUDENT APPLICATION

Personal Information

 

Last Name:

Middle Name:

First Name:

Former Name:

Home Phone:

Work Phone:

Mobile Phone:

E-mail Address:

Street Address:

City, State and ZIP:

Date of Birth:

Gender:

 

Education History

 

High School Attended:

 

Did you graduate?

 

Graduation/GED Date:

 

 

College or Technical School/Program:

Program of Study:

Years Attended:

Did you graduate?

 

 

College or Technical School/Program:

Program of Study:

Years Attended:

Did you graduate?

 

 

Employment History

 

Are you currently employed?

 

Employer Name:

Dates Worked

Position:

 

 

Employer Name:

Dates Worked

 

Position:

 
   

Employer Name:

Dates Worked

 

Position:

 

 

 

Volunteer History

 

Organization:

Position:

Dates:

 

 

 

 

Organization:

Position:

Dates:

 

 

 

Background

 

Have you ever been convicted of a felony?

 

If yes, explain:

 

 

Pharmacy Experience

 

Have you ever worked as a pharmacy technician?

 

Have you ever taken any formal pharmacy technician training courses/classes?

 

 

If yes, explain:

 

 

 

Briefly state why you are interested in a career as a pharmacy technician:

 

 

How did you hear about the Pharmacy Technician Training Program? 

 

Online
 or Other (please describe below)