PHARMACY TECHNICIAN APPLICATION
Name ___________________________________ SID #____________________ Other names ___________________
Mailing Address ___________________________ _____________________________ _________________________
Day Phone #: (
) _____________ Evening/Other Phone #: (
) __________ e-mail: ______________________
1. WHAT IS YOUR GOAL FOR ENTRY INTO THE PHARMACY TECHNICIAN PROGRAM?
 Fall ______  Spring ______
Year
Year
2. APPLICATION REQUIREMENTS
PLEASE
CHECK



TO BE ELIGIBLE FOR THE SELECTION INTO THE PHARMACY TECHNICIAN PROGRAM ALL STUDENTS MUST
COMPLETE THE FOLLOWING :
Complete the Clark College Application for Admission and the Pharmacy Technician Application. Return
them to Clark College Enrollment Services with the $50.00 non-refundable program application fee; all fees
subject to change. Students who are brand new to Clark College must also pay a one-time non-refundable $25.00
application fee. Date of Pharmacy Application (fee paid date) will be considered in selecting students for
entry into the program.
To comply with Washington State Law [WAC 246-901-030(2)], Clark College requires that students must submit
proof of high school graduation, GED completion, or U.S. degree conferment to be eligible for selection into the
Pharmacy Technician program. Students must submit official transcripts in a sealed envelope to the Clark College
Admissions Department.
Submit official college transcripts if you have transfer credits you wish to apply to the program. Students who do
not plan to apply transfer credits toward the program are not required to submit official transcripts . Course credit
hours and equivalency will be determined by Clark College.





Complete Medical Terminology I* (BMED 110), Computer Application Essentials (BTEC 149), Healthcare
Delivery & Career Exploration (HEOC 104), and AIDS Education (HEOC 120 or proof of valid 4-7 hour AIDS
Education certificate) with a grade of 2.0 or higher. *Must be 7 years current upon program entry.
Clark College cumulative GPA of 2.5 or higher
Compass Writing Skill score of 78 or completion of English 098 or equivalent with 2.0 or better grade.
Compass Reading score of 74 or completion of READ 087 or equivalent with 2.0 or better grade.
Compass Pre-Algebra score of 54 or completion of Math 030 or equivalent with 2.0 or better grade. (Must be 7
years current upon program entry.)
3. ADDITIONAL REQUIREMENTS TO BE COMPLETED WITH A 2.0 OR HIGHER GRADE BY THE POSTED DEADLINE BELOW
PLEASE
CHECK
COURSE #
CREDIT
COURSE NAME
HOURS
PRIOR TO ENTERING THE FIRST QUARTER OF THE PROGRAM

HEOC 100 or
BIOL 164 and 165

FACPR 032

BMED 138
Basic Concepts of Anatomy and Physiology w/Lab or Human Biology
w/Lab (must be 7 years current upon program entry).
First Aid and Health Care Provider CPR (may substitute with current American
4-5
Heart Association Health Care Provider level CPR and First Aid cards).
1
Legal Aspects of the Medical Office
2
PRIOR TO ENTERING THE SECOND QUARTER OF THE PROGRAM


CMST& 210 or 230
BMED 111
Interpersonal Communication or Small Group Communication
Medical Terminology II (must be 7 years current upon program entry).
5
3
If you are currently enrolled in any of the above courses at a college other than Clark, you must enclose a copy of your registration with this
application. This information is needed each quarter you enroll at another college.
I have reviewed the program requirements on the Clark College website. I am aware of entrance requirements, selection processes, required
immunizations, criminal background issues, and all other specific program information. I am aware that completion of pre-entrance requirements
does not guarantee entrance into the program, and understand that additional preparation may be needed for final program selection.
_______________________________________
Signature
© HEOC
_______________________
Date
PHAR application.doc 10/24/2014