This website uses scripting to enhance your browsing experience.
Enable JavaScript
in your browser and then reload this website.
This website uses resources that are being blocked by your network. Contact your network administrator for more information.
Ignite Your Journey: Apply Now and Blaze Your Trail with Vincennes University!
Pharmacy Technology Application
Loading...
Please indicate which Program/Campus combination you want to be evaluated for
Please indicate which Program/Campus combination you want to be evaluated for
Pharmacy Technology (AS Degree) - On Campus
Pharmacy Technology (Certificate) - On Campus
Pharmacy Technology (AS Degree) - Distance Education/Online
Pharmacy Technology (Certificate) - Distance Education/Online
→
Personal Information
*Legal First Name
Legal Middle Name
*Legal Last Name
Former Last Name (if applicable)
*Birthdate
*Birthdate
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
1909
1908
1907
1906
1905
1904
1903
1902
1901
1900
*Phone #
*Email Address
*Please Pick 1 Unique Identification # to Enter
*Please Pick 1 Unique Identification # to Enter
Student ID # (A#)
Social Security Number (SSN)
*Student ID # (A#)
*Social Security # (SSN)
→
Other Information
If you completed a GED, please type the code
A04202
in the High School Name field
If you attended an International HS, please type the code
A00026
in the High School Name field
If you attended a Homeschool, please type the code
970000
in the High School Name field
HS CEEB Code
*High School Name
*Year of HS Graduation
*Year of HS Graduation
January
February
March
April
May
June
July
August
September
October
November
December
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
*Have you attended colleges other than VU? Please note this includes colleges/universities you may have received dual credits from while in High School
*Have you attended colleges other than VU? Please note this includes colleges/universities you may have received dual credits from while in High School
Yes
No
*If yes, please list all colleges/universities below:
*Official Transcripts must be on file at Vincennes University.*
Have you ever been convicted of a felony or misdemeanor?
Have you ever been convicted of a felony or misdemeanor?
Yes
No
If yes, please indicate the charge, and explain the event/circumstances leading to the charge.
*Please refer to our website
www.vinu.edu/healthcareers
for information on our criminal history policy/procedure *
Do you currently have any criminal charges pending or are you involved in a pre-trial diversion?
Do you currently have any criminal charges pending or are you involved in a pre-trial diversion?
Yes
No
If yes, please explain
Do you currently hold or have you ever held licensure for any health care related field?
Do you currently hold or have you ever held licensure for any health care related field?
Yes
No
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
License #
Has there been any disciplinary action taken against this license or have you ever been denied licensure/permit for any health care profession ?
Has there been any disciplinary action taken against this license or have you ever been denied licensure/permit for any health care profession ?
Yes
No
If yes, please explain below:
Do you have any additional comments/information you would like to include?:
→
Final Student Checklist
(Do Not Submit Until All Items Checked)
HS Transcript or GED sent to Vincennes Univeristy
Send in College/University Transcripts
Completed Accuplacer Test? (or have other alternate test scores on file?)
Vincennes University does not discriminate based on race, religion, color, national origin or ancestry, age, sex, sexual orientation, or handicap or against disabled veterans and veterans of the Vietnam Era, or other non-merit factors in its
employment or educational programs or activities.
The receipt of this application does not imply that the applicant will be admitted to the program. By signing below you certify that you have received copies of VU’s Pharmacy Technology general information, policies and procedures, including health form requirements, criminal history and drug screening requirements located in the general information packet at
www.vinu.edu/healthcareers
. If selected for admission, the applicant understands that all requirements listed in the general information and/or admission acceptance packet are required and agrees to fulfill all requirements at the applicant’s expense.
*Signature
Date
Date
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
By signing above, you affirm that the information on this application is correct. Falsification of your application may result
in your denial of admission to the College of Health Science and Human Performance and/or Vincennes University.
Submit
