Applications - University of South Carolina

South Carolina College of Pharmacy
Board Application Process
MUSC Campus
Name information
ON ALL documents, list your name
EXACTLY as it appears on the government issued ID you plan
to present at testing
College Affidavit and Certification of Clinical
Experience – Completed Online
 The MUSC campus Dean will be completing the
College Affidavit (top of page 6) and Certification of
Clinical Experience (page 8) components of the SC
Board of Pharmacy Application for Examination.
 The student is responsible for printing and completing
the rest of the application
• South Carolina application can be found:
Application for Examination
If you are applying for your license in any other state, let Diane
Reeves ([email protected]) know as soon as possible so they can
fill out the necessary forms for those states.
Also, make sure you look up the deadlines for application for your
state as every state’s application process if different. Some states
require you to complete an online application.
Make sure you have met the hours of practical experience
requirements, which may vary according to state
SCCP Application Process
Students will be notified by email after the college affidavit
portion and certification of Clinical Experience forms have
been completed and are available to be picked up
Application cannot be completed until the student has
completed their final rotation.
Cannot receive school seal from office of enrollment
services until all grades have been posted and verified.
Completed Applications
 If you are out of state and wish for your forms to be
mailed to you.
 Email me [email protected] with the request and
current mailing address
 Please do not have someone else pick up you
Practical Experience
(Page 4)
 List practical experience under the supervision of a
licensed pharmacist in chronological order.
 These are your Internship hours, not your rotations
College Clerkship or Rotations
(page 4)
There is only room to put 4 of your nine or ten rotations on
this section of the form
You may list the first four and below write (see attached)
On a separate sheet of paper list the remaining rotations in
chronological order making sure to put your name on the
attachment – or (write see attached) and print your rotations
from e*value, it will have your name printed and your rotations
in chronological order.
Previous Examination Record
Previous Licensure as Pharmacist
(Page 4)
 If applicant has previously taken the Board
examination for pharmacist licensure in this or
any other state, he must disclose places, dates
and results in the following spaces.
 If none, type N/A
(Page 5)
 Please read the instructions and complete the
statement as listed on the form
Affidavit Section of Form
 Make sure you sign this portion of the form
 Have form notarized by Faye Ratliff, or other
Notary Public
Proof of Qualifications
Birth Certificates
Have a certified copy of your Birth Certificate. Please note that the birth
certificate you submit Will be returned to you.
Birth Certificates may be obtained by contacting:
Columbia, SC
Office of Vital Records SC DHEC 2600 Bull Street, Columbia, SC 29201
(803) 898.3630; 8:30am-4pm
Processing: mail order may take weeks, phone or online will take 5-7 business
days, walk-ins will take approx. 1 hour
Processing fee of $12-$17
Charleston County Public Health Department
4050 Bridgeview Drive, Suite 475
North Charleston, SC 29405
(843) 746.3801
Proof of Qualifications
Birth Certificates
Out of state students will need to check in their respective home states for a
certified copy of you birth certificate.
Do no delay as this process could take some time to complete depending on
your place of birth.
In most cases, a simple online search will direct you to the correct government
agency to request a birth certificate
There will likely be a fee for requesting a birth certificate
Character Vouchers
(Page 6)
Students will have this portion completed (after they receive the completed
College Affidavit portion from the College with the school seal)
Character Voucher A & B must be completed and signed by two licensed
The signatures for Character Vouchers A & B must also be the signatures
on the (A)(B) lines on the back of the pictures (page 7).
One picture will be submitted with the completed application.
One picture to be presented by the applicant at the time of examination
Certification of Clinical Experience
(Page 8)
Must be completed by the College and signed by the Dean
If you are applying for licensure in another state you will have to
complete this form and send to:
South Carolina Board of Pharmacy
LLR Office of Licensure and Compliance
110 Centerview Drive, Suite 201(29210)
Post Office Box 11927
Columbia, SC 29211-1927
Affidavit of Eligibility
(Page 9-10)
 ALL applicants for a South Carolina license after
July 1, 2008, are required to complete and sign the
Affidavit of Eligibility
 Please check the acceptable secure and verifiable
document(s). A copy of the verifiable document(s)
must be attached to the Affidavit of Eligibility.
Application Submission
Submit your entire Application for Examination to avoid confusion and missing segments
Pay the $100.00 fee.
Enclose Certified copy of your birth certificate
Enclose One picture with signed attachment
*Keep 2nd picture with 2 signatures to present when taking the exam!
Enclose Certification of Clinical Experience signed by Dean
Enclose attachment stating you have completed the NAPLEX/MPJE registration with the
National Association of Boards of Pharmacy (NABP) sign your name on the attachment (see
example on following slide).
Mail Application to or Hand deliver application to:
South Carolina Board of Pharmacy
110 Centerview Drive, Suite 201
Columbia, SC 29210
Once the Application is submitted, students may check the status of their Application on the LLR
website. Your application is valid for one year.
I, _________________________________________, have
completed the registration for the NAPLEX/MPJE with the
National Association of Boards of Pharmacy (NABP).
Application Submission
Students may complete the NAPLEX AND MPJE
registration processes with the National Association of
Boards of Pharmacy (NABP) prior to submitting their
SC Board of Pharmacy Application for Examination; this
is a separate process.
SCCP degree candidates should select:
SC 104 South Carolina College of Pharmacy from
the School Code List when submitting their NAPLEX
and MPJE registrations.
Application Submission
Applications for GA, ALABAMA, NORTH CAROLINA AND TEXAS as well as SOME
GRADUATION OR AFTER GRADUATION, Enrollment Services will not apply the school
seal for these States until the day of Graduation or after graduation. You may pick up the
college affidavit portion of these applications when you receive your Diploma (following
graduation), from Diane Reeves
Make sure you look up the deadlines for application for your state as every state’s
application process is different.
Initial Licensure Process
After passing the NAPLEX and MPJE, you will receive a Pharmacist’s
Initial Licensure Application and an information sheet.
Both forms must be completed and submitted along with a $70 initial
licensure fee.
This process must be completed no more than 30 days after receipt.
Cost Associated with SC
Licensure Process
=$210 per state (credit card only)
=$505 exam fee (credit card only)
Submission fee
=$100 (check or money order)
Initial Licensure
=$70 (check or money order)
Total for SC
Licensure process

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