Pharmacy Technician Scholarship Application

Please read the general information and instructions for this scholarship before completing this form.

Name*
First Last
Email*
Address While At School*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Student ID Number*
Birthdate & Birthplace*
Name of College Enrolled*
Grade Point Average (GPA)*
How long have you been an Alaska resident?*
Name and Address of High School Attended*
Parent's Name, Address and Phone Number*
Other Awards or Honors Received
Upload Your School Transcript Here*
Upload Your First Letter of Recommendation Here
Your reference can email his/her letter to akphrmcy@alaska.net instead with your name in the Topic Line. Letters must be received before November 30th. AKPhA is not responsible for non-receipt of emailed letters.
Upload Your Second Letter of Recommendation Here
Your reference can email his/her letter to akphrmcy@alaska.net instead with your name in the Topic Line. Letters must be received before November 30th. AKPhA is not responsible for non-receipt of emailed letters.
Upload Your Personal Statement Here*
One to two pages addressing: 1. Alaskan Background 2. Financial need for this scholarship 3. Your technician career goals and plans for program completion. 4. How you plan to help AKPhA in helping others
Certification*
I agree
All of the information provided is complete and accurate to the best of my knowledge. I hereby give AKPhA permission to share this information for the purpose of recruitment, public relations and possible employment. I further certifiy that I am currently enrolled as a student and will use the AKPhA award toward the expenses related to my college attendance.

I hereby acknowledge that it is my responsibility to keep AKPhA informed of any address change. Furthermore, I am aware that any scholarship check I may receive will be issued to the financial aid office of my college of pharmacy on my behalf. Falsification of information may result in termination of any scholarship granted and render me disqualified for further consideration of this scholarship. All application material becomes the property of AKPhA.

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