PACIFIC UNIVERSITY
SCHOOL OF PHARMACY
TRANSFER APPLICATION FOR ADMISSIONS
PERSONAL/BIOGRAPHICAL INFORMATION
LEGAL NAME
Last
First
Middle
Preferred First Name
Other names that may appear on transcripts (if different)
Current Address:
Street
City
State
(
)
Home Telephone
_____________________________
E-mail
Apartment Number
Zip/Postal Code
(
)
Work Telephone
Country
(
)
Cell Telephone
____________________________________ ______________________________________
Alternate E-mail
Date of Birth
PERSONAL DATA
U.S. Social Security Number
(Leave blank if you currently do not have a U.S. social security number.)
Have you attended Pacific University before?  Yes  No If Yes, when?
Are you a graduate of Pacific University?
______________ to ______________
(MM/YYYY)
(MM/YYYY)
 Yes  No
Have you applied to Pacific University School of Pharmacy before?  Yes
 No
When?
How did you first hear of Pacific University?
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Who or what influenced you to apply?
___________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
PACIFIC UNIVERSITY
SCHOOL OF PHARMACY
GPA CALCULATION FORM
READ THESE DIRECTIONS CAREFULLY:
Convert all quarter credits to semester credits using the chart below.
Hour Conversion Table
Quarter
Semester
Credits
Credits
1
÷ 1.5 = 0.667
2
3
4
5
÷
÷
÷
÷
1.5 =
1.33
1.5 =
2.00
1.5 =
2.67
1.5 =
3.33
1.
2.
Convert all quarter credits to semester credits before you calculate your Last 45 GPA.
Compute your GPA for the most recent 45 semester credits (68 quarter credits). If the last 45 semester
credits fall in the middle of the semester/quarter, you may choose which courses to use, but stay within the
range of 42-48 semester credits.
3. You must have a minimum Last 45 semester credits GPA of 2.7 .
4. Transcripts from each college and university attended must be used in calculating your Last 45 GPA. This
includes course-by-course evaluations for international programs and any transcripts from undergraduate,
graduate or professional programs.
5. All graded courses from all transcripts (including all repeated courses and refresher courses) must be used
in calculating the Last 45 GPA. Pass/fail courses are not used in this calculation.
6. If your institution uses a different grading system, complete the table below to the best of your ability and
use the Optional Essay portion of this application to include an explanation of your work and calculations.
7. Miscalculation or misrepresentation of your GPA will result in the disqualification of your application.
8. If a “repeated/retaken” course falls within the Last 45 semester credits of the original/initial course, you
must include both grades in the GPA calculation. You must do this even if your institution does not
include these grades in their GPA calculation.
LAST 45 SEMESTER CREDITS GPA
Semester
X
GRADE
Credits
= POINTS
4.0 – 3.80
A
x 4.0
3.79 – 3.60
Ax 3.7
3.59 – 3.40
AB
x 3.5
3.39 – 3.10
B+
x 3.3
3.09 – 2.80
B
x 3.0
2.79 – 2.60
Bx 2.7
2.59 – 2.40
BC
x 2.5
2.39 – 2.10
C+
x 2.3
2.09 – 1.80
C
x 2.0
1.79 – 1.60
Cx 1.7
1.59 – 1.40
DC
x 1.5
1.39 – 1.10
D+
x 1.3
1.09 – 0.80
D
x 1.0
0.79 – 0.60
Dx 0.7
0.59 -0.40
DE
x 0.5
≤ 0.39
F
x 0
Total Semester Credits =
Total Points ÷ Semester Credits =
Total Points =
GPA
YOUR LAST 45 SEMESTER GPA MUST BE A MINIMUM OF 2.7 IN ORDER TO BE CONSIDERED FOR
PACIFIC UNIVERSITY SCHOOL OF PHARMACY.
PACIFIC UNIVERSITY
SCHOOL OF PHARMACY
OFFICIAL PREREQUISITE WORKSHEET
Please Read the Following Directions CAREFULLY





Convert ALL coursework to SEMESTER CREDITS.
quarter credit ÷ 1.5 = semester credit
Example:
3 quarter credits ÷ 1.5 = 2 semester credits
Do NOT use PASS/FAIL coursework.
Grades of “C” or better only (“C-“ or lower not
acceptable)
A single course may not be used in more than one
area.
Science courses must be designed for science
majors or pre-professional students.





RETAKES: If you repeated a course (or plan to retake a course),
please list the initial course first. Mark the “R” column for that
course and list the retaken course in the next row, below the
initial course.
All prerequisite courses must be completed by mid-July before
the program begins in August.
Please list all planned courses for finishing prerequisites and the
dates when and institutions where these courses will be
completed.
Science courses recommended to be taken within the last 7
years.
Bachelor’s degree not required, but does strengthen application.
BIOLOGICAL SCIENCES: 19 semester credits
Must include:

General Biology w/labs – 8 semester credits

Microbiology (lab not required) – 3 semester credits

Anatomy and Physiology w/labs – 8 semester credits
Dept. & No.
Prefer human anatomy, human physiology; year long series; courses taken at the same institution; combined courses acceptable.
Semester
Lab
Date
To Be
Course Title
Grade
R
Institution
Credits
Y or N
Completed
Completed
CHEMISTRY: 16 semester credits
Must include:

General Chemistry w/labs – 8 semester credits

Organic Chemistry w/labs – 8 semester credits
Dept. & No.
Course Title
Semester
Credits
Grade
Lab
Y or N
R
Date
Completed
To Be
Completed
Institution
PHYSICS: 3 semester credits
Must include:

General or upper-level Physics w/lab – 3 semester credits
Semester
Dept. & No.
Course Title
Grade
Credits
MATHEMATICS: 3 semester credits
Lab
Y or N
R
Date
Completed
To Be
Completed
Institution
(2.67 semester credits acceptable)
Must include:

Calculus – 3 semester credits
Dept. & No.
Course Title
Semester
Credits
Grade
R
Date
Completed
To Be
Completed
Institution
To Be
Completed
Institution
To Be
Completed
Institution
To Be
Completed
Institution
To Be
Completed
Institution
ENGLISH: 6 semester credits
Must include:

English Composition – 3 semester credits

Other English (composition, literature, creative writing, poetry, etc.) – 3 semester credits
Semester
Date
Dept. & No.
Course Title
Grade
R
Credits
Completed
SPEECH: 3 semester credits (2.67 semester credits acceptable)
May include:

Speech, Communication, Debate, etc.:
Dept. & No.
Course Title
Semester
Credits
Grade
R
Date
Completed
PSYCHOLOGY: 3 semester credits (2.67 semester credits acceptable)
Must include:

Introduction to Psychology or Abnormal Psychology
Semester
Dept. & No.
Course Title
Credits
Grade
R
Date
Completed
ECONOMICS: 3 semester credits (2.67 semester credits acceptable)
Must Include:

Microeconomics or Macroeconomics
Dept. & No.
Course Title
Semester
Credits
Grade
R
Date
Completed
SOCIAL/BEHAVIORAL SCIENCES: 3 semester credits (2.67 semester credits acceptable)
May Include:

Anthropology, Government, Human Development, Political Science, Psychology, Sociology, Philosophy, Geography, History, etc.
Semester
Date
To Be
Dept. & No.
Course Title
Grade
R
Institution
Credits
Completed
Completed
HUMANITIES/FINE ARTS: 3 semester credits (2.67 semester credits acceptable)
May Include:

Geography, Religion, History, Foreign Language, Literature, Drama, Performance Arts, Visual Arts, etc.
Dept. & No.
Course Title
Semester
Credits
Grade
R
Date
Completed
To Be
Completed
Institution
ESSENTIAL JOB FUNCTIONS
The following information identifies the functions required for the successful completion of the Pacific University
School of Pharmacy program:
1.
Physical Skills – Stand, sit, bend and reach while performing clinical assessments and dispensing
functions. Function in a structured environment for several hours. Move freely and maneuver in small
spaces. Demonstrate hand/eye coordination. Perform cardiopulmonary resuscitation (CPR) and assist in
emergency situations. Provide immunizations to patients. Effectively manage physical conditions in
order to prevent impediments to appropriate services.
2.
Sensory Skills – Read patient profiles – CRT/LCD/other monitors, printouts, small print and/or
handwritten notes. See with measurable depth perception and in low-light conditions. Distinguish color
variations and discern shades of black and white. Hear, understand and accurately communicate the
information/directions verbally and in writing. Discern sounds related to patient assessment and
treatment. Distinguish smells of various drugs and solutions used in health care settings. Recognize
changes in patient status and feel subtle differences in skin temperature.
3.
Cognitive Skills – Comprehend, analyze and synthesize complex science and clinical content. Apply prior
learning to new situations. Concentrate on task at hand amidst a variety of environmental distractions,
including noise and interruptions. Interpret patient findings, recognized anomalies and make
recommendations which improve patient care. Use personal computers to complete assignments.
Complete standardized tests within established time limits. Need to be able to manage one’s realities in
ways that do not restrict balanced services to their patients/clientele.
4.
Communication Skills – Speak and write English clearly. Provide patients with clear drug information
and instructions appropriate for their level of understanding. Document clear and legible handwritten
notes. Organize thoughts and ideas into appropriately written and referenced essays and research papers.
5.
Interpersonal Skills – Interact with individuals, small groups and large audiences. Establish sufficient
rapport and maintain boundaries in order to effectively relate to fellow colleagues, patients, health care
professionals, faculty and staff. Demonstrate concern and empathy for a diverse population of patients.
6.
Professional Skills – Present a professional appearance and maintain personal health. Maintain
composure during stressful situations. Work both independently and as a team member. Organize tasks,
set priorities, problem solve and multitask. Maintain accuracy and confidentiality of patient information.
Comply with established policies and procedures. Provide care to all patients regardless of age, race,
ethnicity, origin, physical or mental status, or other conditions.
PROGRAM SPECIFIC REQUIREMENTS
 The program consists of a modified block system and the blocks are administered on a Pass/No
Pass basis. Pass is based on a 90% competency.
 Following an invitation for admission, each student must satisfactorily complete a criminal
background check and a drug test (completed through PharmCAS Centralized Background Check
and Drug Screening Program), and must attain intern licensure by both the Oregon and
Washington State Boards of Pharmacy prior to the start of orientation. Licensure in both states
must be maintained for the duration of the Program.
 Experiential rotation placements (both introductory and advanced) may require the student to
relocate outside of the Portland area for time ranges of 3 weeks to the entire P3 year.
ACKNOWLEDGEMENT
I have read and understand the Essential Functions for the School of Pharmacy program. I am able to
perform all of the skills needed to satisfactorily complete the requirements for this program. In addition,
I have read and understand the Program Specific requirements needed to successfully begin my
pharmacy education.

I agree.
Name: _______________________________________
Date: _______________
ENGLISH LANGUAGE PROFICIENCY
Is English your native language?
 Yes  No
If no, the English proficiency requirement has been satisfied by one of the following:
 I have received, or will receive, a Bachelor’s Degree or higher from an English-speaking institution by
Summer/Fall 2015, and would like this degree considered as a demonstration of my English proficiency.
College/University attended: ___________________________________
Degree: ________________
Date received, or will receive: ______/______/______

 Qualifying TOEFL/IELTS scores: Overall: _____________ Date taken: __________________________
Section scores: Reading _________ Listening _________ Writing _________ Speaking _________
 I have not yet taken the TOEFL/IELTS exam, but plan to, and believe my scores will meet the requirement.
Planned date of exam: ______/______/______
PLEASE ENTER YOUR SELF-CALCULATED GPA FROM YOUR GPA WORKSHEET:
Last 45 Semester Credits GPA:
Essay Questions
Respond to question 1 and 2. Each response is limited to 500 words. Please complete in a word processor (Ex. Word), print, and include
with application materials.
1.
Knowing what you do about Pacific University’s School of Pharmacy, what personal strengths, skills, or assets do you believe
make you a strong candidate?
2.
Tell us about an experience that shaped you, and how it will have a lasting effect on your future endeavors, both personal and
professional.
3.
OPTIONAL for all applicants: Please take advantage of this opportunity to state any additional pertinent information (academic,
personal or application related) that you think the Admissions Committee should take into consideration while evaluating your
application.
I affirm all the information contained in this application is true and correct to the best of my knowledge. I understand the falsification
of any part of this application is grounds for my disqualification for admission or dismissal from the program. In addition, I understand
this application becomes the property of Pacific University and is not returnable. I further understand the application is accessible to
faculty, staff, and members of the Admissions Committee.
 I affirm.
Signature
Date