APPLICATION | AVPTS.COM

First name

Last name

Email

Address

Birthday

Month

Day

Year

Phone

I hereby certify that I’m 18 years of age and I have a high school diploma/GED or equivalent, valid ID, and agree to provide a copy of each item to the school when requested.

Enter your school's address and year where you received your HS diploma or GED equivalent (Example: Yuma High School 400 S).

Emergency Contact

Please list the phone number and the name of your contact person (Example: Jane Doe: 602- 345-0700).

I realize that I must obtain a Fingerprint Clearance Card and be capable of meeting all of the Health and Safety requirements prior to the start date of the externship.

Social Security Number, Drivers License, or State ID (please include the state where your drivers license

(EXAMPLE: AZ, D12345678 or SS: 000-00-0000)

Do you confirm that you have a computer with webcam capability, smart phone, high speed internet, and the proper equipment to receive incoming calls or e-mails to complete the assignments in the program?

Do you require financial assistance to help with the cost of your tuition and would you be interested in receiving a scholarship if chosen?

AVPTS (Arizona’s Virtual Pharmacy Tech School) will use the information you provided to conduct a background check to determine the validity of your application (A check mark in the box will have the same force an effect as a hand written signature).

Do you require any special accommodations that is qualified under the ADA to complete this program?

Yes

No

Please only check one box.

https://bit.ly/4iLZeTH

I have reviewed the Course Catalog and I agree to all of the the terms and conditions set forth in Arizona’s Virtual Pharmacy Tech School Course Catalog (click on the link to view the catlog).

https://bit.ly/4iM1jPv

I have reviewed the Enrollment Agreement and I agree to the terms and conditions set forth in this agreement (click on the link to view the agreement).

https://bit.ly/4ivM64Q

Every student has to apply for funding (even if you don't need any financial assistance). Please make sure to view the funding link.

The Enrollment Agreement will be populated with the information that was provided in this application and will serve as your official agreement after approval (A check mark in the box will have the same force an effect as a hand written signature).

Program Application

$20.00

Registration is not final until the application and payment are complete. You can pay with other payment methods after you enter your contact information.