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Applying to the Pharmacy Technician Training Program

To apply to the UW Health Pharmacy Technician Training Program, complete the form below and select the Submit button.

 

If you would prefer to submit a hard copy application, you may print and complete the Pharmacy Technician Training Program Application for Admission (pdf). There is no cost to apply to the Pharmacy Technician Training Program.

 

Please note: Incomplete applications will not be considered.

 

Dates to remember:

  • Fall 2014 classes start September 2, 2014; we are currently accepting applications

Minimum Applicant Requirements

 

Applicants for the program must have met the following requirements:

  • Possess a high school diploma or equivalency certificate
  • Have at least two years professional work experience
  • An updated resume
  • Applicants must be eligible for employment in the United States

 * required field

 

Personal Information

 

*Name:

 

*Phone:

E-mail Address:

*Street Address:

City, State and ZIP:

*Date of Birth:

Gender:

 

Emergency Contact Information:

 

Name:   Phone:

 

Name:   Phone:

 

 

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

 

Previous Employer Name:

Dates Worked

Previous Employer Name:

Dates Worked

 

 

Professional/Academic References

 

Reference Name:

Organization:

Phone:

E-mail Address:

 

 

Reference Name:

Organization:

Phone:

E-mail Address:

 

 

Pharmacy Experience

 

Have you worked at a pharmacy?

 

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

 

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

 

 

How did you hear about the Pharmacy Technician Training Program?