Corporate Enrollment

Please fill out this form in its entirety to enroll in our PTCB-recognized Pharmacy Technician Education Program. Your organization should have supplied you with a corporate code to enter on this form, which will allow you to enroll under the group contract. Upon completion of this form, you will be enrolled in our course and will have access using the Username and Password that you set in the form.

"*" indicates required fields

Personal Information

Name*
MM slash DD slash YYYY
Address*
This information is necessary both for payment processing and for our records. The Pharmacy Technician Certification Board can request documentation on who has completed our course when processing exam applications, and this information is necessary for student identification.
This will be the User ID that you use to log into the course.
Password*
Strength indicator
This will be the password to be used along with your Username to log into the course.

Terms of Use

Acceptance of the Pharmacy Tech Scholar Terms of Use*

Payment Information

6-months of access to the 120-Hours to CPhT by Pharmacy Tech Scholar Online Course (access can be renewed at a discount in 1 to 3 month increments if needed)
This field is for validation purposes and should be left unchanged.