State Board of Pharmacy: Pharmacist, Pharmacy Intern, andState Board of Pharmacy: Pharmacist, Pharma 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out Part A: Applicant Information. Enter your first name, middle name, last name, and social security number. Ensure all fields marked with an asterisk are completed.
3. Provide your contact details including home phone, cell phone, email address, and permanent mailing address. If applicable, indicate if you are a military member or spouse requesting expedited review.
4. Complete the Post-Secondary Education section by listing all schools attended in chronological order. Attach additional pages if necessary.
5. In the Employment Plans section, check whether you are currently working as a pharmacy intern and provide the pharmacy registration number if applicable.
6. Answer all questions in the Personal History Information section honestly. If you answer 'Yes' to any question, attach Form S-150: Personal History.
7. Review your application for completeness before submitting it along with any required fees and supplemental materials.

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