Section Ph 808.02 - Application Procedures for Certified Pharmacy Technicians(a) Pharmacy technician applicants shall complete and submit an application form "Initial Application for Pharmacy Technician Registration" form PT-1, or electronic equivalent, for certification by the board that contains the following:(1) Legal name, residence address, mailing address, home telephone number, personal e-mail address, and social security number of the applicant;(2) Date and place of birth, and gender of the applicant;(3) Name of current employer and the mailing address, and phone number of employment site;(4) Name of supervisor and pharmacy phone number;(5) An indication as to whether or not the applicant has been convicted of a drug or pharmacy-related felony or admitted to sufficient facts to warrant such a finding, and if yes, an explanation of the circumstances surrounding such a finding or conviction;(6) An indication as to whether the application has any other felony convictions and, if so, an explanation of such convictions; and(7) Applicant's signature and date.(b) The prescribed fee shall be $100, and shall be submitted with the completed application form.(c) "The Initial Application for Pharmacy Technician Registration" form for pharmacy technicians in New Hampshire may be obtained from and shall be filed at the office of the board, identified in Ph 103.03.N.H. Admin. Code § Ph 808.02
Derived From Volume XXXVIII Number 50, Filed December 13, 2018, Proposed by #12671, Effective 11/17/2018, Expires 11/17/2028.