Application for The NJ CCP Exam on Friday, October 9, 2026
Location: Penn Medicine Princeton Medical Center 1 Plainsboro Rd, Plainsboro NJ, 08536 Check in: 8:30am. The exam starts promptly at 9am Non-refundable Application Fee: $129 ($125 plus a $4 credit processing fee) must be received to hold your spot. Questions may be directed to csilvestri.jbccp@gmail.com
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
NJ Pharmacy License # with expiration date:
*
Other States Licensed:
Please specify the SCHOOL from which you graduated with your primary degree in Pharmacy and YEAR of graduation.
*
Please list any additional degrees, certificates or fellowships received:
Employer with city/state
Current Practice Site Type:
Retail
Hospital
Industry
Government
Consulting
Other
If Consulting please check all that apply:
Long Term Care Facility
Assisted Living
Medical Day Care Center
ICF/IID
Hospice
Hospital
Veteran’s Administration
Clinic
Surgical Center
Dialysis Clinic
Corrections Facility
Substance Abuse
Federal/State Surveyor
Education
Other
Applicants will be required to certify that 24 Continuing Education (CE) credits were completed within the 12 months prior to this examination, as defined in Section I..B.i,of the Certification Board Policies and Procedures. Please submit proof of your CE credits to the Joint Board with this application. Have you submitted electronic proof of CE to csilvestri.jbccp@gmail.com?
JBCCP will hold your spot on receipt of this application, CE Proof and the registration fee.
The Joint Board may release my professional and contact information:
*
Please Select
For employment opportunities only
Do NOT release my personal information
Applicant Signature
*
Attestation: All information provided herein is valid, accurate and complete and I understand that misrepresentation may result in the forfeiture of my certification
Payment Link:
https://buy.stripe.com/eVq00leyT8jd4U7795cZa00
Should be Empty: