Online Notification Form for Pharmacy Technicians

PLEASE NOTE: This form must be sumitted PRIOR to beginning training of Pharmacy Technicians. Approval must be given by the Division before beginning a program. Training done in a non-approved program will not be given credit, and training will have to be repeated in an approved program.

You will need to specify the following information:
  • Citizenship
  • SSN and/or Driver License Number
  • Personal Contact Information
  • If attending a Formal Training Program
    • The Name of the School
  • If receiving On-The-Job Training
    • The Name of the Pharmacy
    • The License Number of the Primary Instructing Pharmacist

All fields on the form with a red asterisk are required.