Pharmacy Tech Scholar Enrollment Form

Please fill out this form in its entirety to enroll in our PTCB-recognized Pharmacy Technician Education Program. 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. If you have any questions or concerns while filling out this form, please email us at [email protected].

  • Personal Information

  • MM slash DD slash YYYY
  • 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.
  • Strength indicator
    This will be the password to be used along with your Username to log into the course. You must enter a password that is at least 12 characters long and reaches a strength indicator of “strong”. Try using phrases that you can remember easily but would be hard for others to guess.
  • Terms of Use and Privacy

  • 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 if needed)

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