PHARMACY TECHNICIAN APPLICATION
 
First Name :    
Middle Name :    
Last Name :    
Maiden Surname :  
WSCC Student ID Number :    
Street Address :    
City :    
State :    
Zip Code :    
 
Home Phone :   Cell Phone :
 
Contact Name (Relative):   Contact Phone :  
 
Student e-mail :      
 
Place of Work Work Phone :
 
Number of hours worked  
 
Inability to contact student may limit admissions process
 
All Colleges, Pharmacy Technician and Health Career Programs attended and dates (including WSCC)(must be completed).
For College Entry and Exit dates, include only month and year.
1. List first college
College Name : College Address :
College Entry Date : College Exit Date :

Would you like to add a college?

 
 
 
 
Specify degree/major :
       
 
If yes, list program:
 
If yes, what was your outcome?
 
 
If you need special accommodations, please explain how you would perform the tasks and with what accommodation(s).
 
 
If yes, please explain.
 
 
If yes, please explain.
 
 
 
If yes, please explain.
 
 
If yes, please explain.
 
 
If yes, please explain.
 
       
COMPASS Assessment (test scores must be less than 3 years old)
 
ACT Math Score: ACT date:   
 
OR
 
COMPASS Math Score: COMPASS Reading Score:
 
COMPASS Writing Score: COMPASS Test Date:
 
 
Current Overall (cumulative) GPA:   
 
Previous college math course successfully completed:
!!!!!!STUDENT RESPONSIBILITY!!!!!!
  • Apply to or update your WSCC application.
  • Complete Pharmacy Technician application (only complete applications will be considered).
  • Have you requested "official" copies of all high school transcripts or GED certificate, and/or college transcripts (excluding WSCC) for submission to the WSCC Admissions Office?  
  • Fulfill math competency assessment and submit scores or classes for verification.
  • Make a personal copy of this application and all records submitted for your personal portfolio.

 

I have read and understand the above student responsibilities.  
 
Questions concerning application? Please call 423-585-6870
 
ALL APPLICANTS MUST READ: by submitting this form you have agreed to the statement below.
I understand that withholding information requested in this application or giving false information may make me ineligible for admission to , or continuation in, Walters State Community College Pharmacy Technician Program. With this in mind, I certify that all the above statements are correct and complete.
       
Walters State Community College · 500 South Davy Crockett Parkway · Morristown, TN 37813-6899
Phone: (423) 585-2600 · Toll Free: (800) 225-4770 · Contact Walters State