Pharmacy Technician Specialist Program Admissions Application

Pharmacy Technician Specialist Program Admissions Application
Application Deadline: July 1st (Annually)

Fall Admissions (Mt. Pleasant Campus)

*Applications received after July 1 will only be accepted IF there are openings in the program.
Applicant Information

Please make sure the information provided is accurate. Letters of acceptance or denial will be emailed to the email address provided below.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail *
Please note that your acceptance/denial letter will be sent to this email
Student ID # *

Transfer Students
For transfer students, all official transcripts have been sent to the Mid Registrar before the application deadline *

Yes No
Driver's License
Criminal Background Check

Admission to the Pharmacy Technician Specialist program is contingent upon students successfully completing a criminal background check with fingerprints. The student is responsible for the cost of the background check. The information for the criminal background check is available on the Pharmacy Technician website at: www.midmich.edu/pharmacy

Students will be excluded from acceptance to the program for any felony conviction record and/or any drug or pharmacy related convictions including misdemeanors. Students will also be excluded from acceptance to the program for any denial, suspension, revocation, or restriction of registration or licensure, consent order or other restriction by any State Board of Pharmacy. Students will also be excluded from acceptance to the program for any admission of misconduct or violation of regulations of any State Board of Pharmacy.
Criminal Background Check

Yes, I have completed a Criminal Background Check
Livescan Form Upload
You should have taken a Livescan Fingerprint Request Form with you when you went to get fingerprinted. This should have been signed by the livescan operator. Please upload a scanned copy of the completed form here.
Additional Requirements/Statements
By checking this box I certify that my answers are true and complete to the best of my knowledge. I am responsible for assuring all documents are received and all required are completed to apply. Late documents will NOT be accepted for consideration.

I agree to and understand this statement
Mid admits students to the Pharmacy Technician Specialist program in the fall of each year, at the Mt. Pleasant Campus Doan Center, only. All classes will be held at the Mt. Pleasant Campus.

I agree to and understand this statement
20 students are accepted into the Pharmacy Technician Specialist program each year.

I agree to and understand this statement
By checking this box, I understand immunizations will be required for the Pharmacy Technician Specialist program.

I agree to and understand this statement
Admission to the Pharmacy Technician Program occurs once a student has received a letter or email from the Pharmacy Technician Program Director stating he or she has been selected to enter the Pharmacy Technician Program.

I agree to and understand this statement
I will notify Mid by calling 989-386-6667, if my phone number, address, or email changes after submitting this application. If we are unable to contact you by the contact information provided, you may miss your acceptance into the program, and will be removed from the wait list.

I agree to and understand this statement
Date

Month Day Year
Campus Safety, Security, and Non-Discrimination Information

In Mid Michigan College’s commitment to provide an environment that is safe, transparent and equitable, Mid publishes an Annual Security Report that outlines safety and security policies, protocols, measures and crime statistics. To learn about these initiative please review the Annual Security Report on Mid’s website at www.midmich.edu/securityreport.


The College’s general consumer information along with financial assistance, graduation and completion rates are available to prospective and enrolled students on the College’s Student Right to Know webpage.

Mid prohibits any form of discrimination on the basis of ‘protected characteristics.’ These include: race, color, religion, sex, gender identity or expression, pregnancy, age, sexual orientation, marital or parental status, national origin, citizenship, genetics, disability, military or veteran status, or any other legally-protected status; as well as victims of intimate partner violence or criminal conviction in the administration of and access to the College’s programs and activities and in conditions of admission or employment. Mid adheres to the principles of all applicable state and federal equal opportunity laws and regulations for its students, staff and applicants for admission and employment.

Mid strongly encourages anyone who experiences or observes any acts of discrimination, harassment, or sexual misconduct to promptly report the incident(s) and seek assistance from the College. Reports may be filed using the online report form or by contacting one of the College’s Title IX Coordinators as follows:

For Students:

Kim Barnes, AVP of Security Operations and Systems
Chief Title IX Coordinator
2600 S. Summerton Rd., Mt. Pleasant, MI 48858
Office: Mt. Pleasant Campus Doan Center, Room 105
(989) 386-6622, Ext. 236
kbarnes@midmich.edu

Martricia Farrell, Director of Security Operations and Systems
Deputy Title IX Coordinator/Clery Compliance Officer
1375 S. Clare Ave, Harrison, MI 48625
Office: Harrison Campus Safety and Security Office
(989) 386-6622, Ext. 394
mfarrell@midmich.edu

Mid’s full Non-Discrimination, Harassment and Sexual Misconduct Policy is available online, along with various other safety and security related policies, procedures and information. Questions may be submitted to sos@midmich.edu.

Significant effort has been made to ensure this content meets accessibility guidelines. If you encounter a barrier, you can report the barrier at midmich.edu/reportaccessibilitybarrier or contact sos@midmich.edu
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Pharmacy Technician Specialist Program Admissions Application

Application Deadline: July 1st (Annually)

Fall Admissions (Mt. Pleasant Campus)

Applicant Information

Transfer Students

Driver's License

Criminal Background Check

Additional Requirements/Statements

Campus Safety, Security, and Non-Discrimination Information

For Students: