Mandatory Orientation for Fall 2016 Student must attend ONE: TBA (see website for dates )

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1 Pharmacy Technician Program San Jacinto College

2 Dear Prospective Student: Thank you for your interest in the Pharmacy Technician Program at San Jacinto College North. To give an overview of what our program can offer in just three terms, please review the following: Certificate of Technology Upon completion of the program, students will receive a certification that is accredited by the American Society of Heath-System Pharmacists (ASHP) / Accreditation Council for Pharmacy Education (ACPE) IV Certification Offered through the National Pharmacy Technician Association (NPTA). Students have the opportunity to become IV certified, which enables them to prepare sterile products in any pharmacy setting. CPR Certification As part of the program students obtain training in Basic Life Support (BLS) Healthcare Provider CPR through the American Heart Association. Experience Students practice and gain experience in retail and hospital settings during two clinical rotations. Pass the Pharmacy Technician Certification Exam Upon completion of the program, students gain the knowledge and skills to pass the national exam. Regular Informational Session dates, detailed program information and application forms are available on our website: or you may pick up an application packet in our office located in Allied Health & Science Building N A package can also be ed to you be contacting irene.banuelos-villatoro@sjcd.edu. Mandatory Orientation for Fall 2016 Student must attend ONE: TBA (see website for dates ) We know this is an important decision and we would be happy to talk with you about how three semesters in our program can prepare you for a successful career as a certified pharmacy technician. We look forward to having you as a student in our program. If you have any questions, please feel free to call me at x7348 or me at the address below. Our new Allied Health & Science Building is now open. Incoming students will enjoy our new state-of-the art facility. Sincerely, Irene Banuelos-Villatoro, BS, CPhT, RPhT Pharmacy Technology -Program Director San Jacinto College North irene.banuelos-villatoro@sjcd.edu

3 This application and this checklist must be filled out completely and brought to the Pharmacy Technician Department during the application period for the semester you want to attend. You must bring all items listed below before we will accept your application. Please check all check boxes as each item is accounted for. North Campus N17- Health/Natural Sciences 5800 Uvalde Rd. Houston, TX Early College Program Dual Credit Program College and Program Application Apply to San Jacinto College Apply to Pharmacy Technician Program (drop off or application form) Background Check and Drug Test Go to: and place order by using the package codes. The program does not accept Background Checks and Drug Test from other vendors, programs or place of employment. North Campus: Background Check: SQ27bg ($29.00) Drug Test: SQ27dt ($27.00) Additional Background Check and Drug Test will be conducted again for Clinical Placement Immunization Records Go to: and place order by using the package code below. The medical document manager stores all of your immunization records and important documents. The cost of vaccinations and testing will not be covered. Candidates will have to pay out of pocket. North Campus: Medical Document Manager:SQ27im ($30.00) Tetanus-diphtheria (Tdap): proof of 1 dose less than 10 years old. Measles, Mumps, and rubella (MMR): proof of 2 doses. If previously vaccinated and shot records are lost or unavailable, immunity can be validated with a titer level (blood) confirmation. Hepatitis B: proof of 3 doses. If previously vaccinated and shot record lost or unavailable, immunity can be validated with a titer level (blood) confirmation. Please note that series takes 4-6 months to complete. Varicella (Chickenpox): proof of 2 doses or documentation of having had varicella or blood test (titer). Influenza (Flu) Vaccine: flu vaccines are good for one year. TB Skin Test (TB/PPD): If you have had a previous positive TB skin test or the BCG (TB) vaccination you must have a chest x-ray performed. TB Skin Tests and Chest X-Rays are good for 1 year. Texas State board of Pharmacy Trainee license (more information on the first day of class)

4 PHARMACY TECHNICIAN CERTIFICATE PROGRAM APPLICATION FORM Personal Information (Please type or print clearly) Application Date: / / Name: Home Address: Last First Middle Street City State Zip Social Security No.: San Jac G#: Date of Birth: / / Phone Number(s): (Home) (Cell) (Work) address: Emergency Contact: Educational Background Name Phone Number High School: City, State Graduation Date: Please select one of the following: 11 th grade 12 th grade Early College Activities/Clubs: Employment History Position: Employer: Dates: Position: Employer: Dates: *Optional Information *Gender: *Date of Birth: *Age: *Ethnicity: *Place of Birth: San Jacinto College does not discriminate on the basis of race, color, creed, national origin, religion, age, gender, sexual orientation, political affiliation, or physical disability. I hereby certify that the information contained in this application to be true and complete to the best of my knowledge. Applicant Signature Date Parent/Guardian Signature Relationship Date

5 List of Required Textbooks for the Pharmacy Technician Program Name of Course Image of Book Name of Book PHRA 1301 Introduction to Pharmacy Manual for Pharmacy Technicians 4th Edition ISBN: PHRA 1305 Drug Classification PHRA 1309 & PHRA 1347 Pharmaceutical Mathematics I & II HPRS 1206 Essentials of Medical Terminology PHRA 1313 Community Pharmacy Practice & PHRA 1349 Institutional Pharmacy Practice PHRA 1441 Pharmacy Drug Therapy PHRA 1345 Intravenous Admixture and Sterile Compounding PHRA 1243 Pharmacy Technician Certification Review Sigler s Prescription Drug Cards 30th Edition ISBN: Pharmaceutical Calculations for Pharmacy Technicians: A Worktext 2nd Edition ISBN: Medical Terminology Get Connected 1st Edition ISBN: Pharmacy Practice for Technicians 5th Edition ISBN: Pharmacology for Technicians 5th Edition ISBN: Sterile Products and Aseptic Techniques 2nd Edition ISBN: Pharmacy Technician Certification Examination 3rd Edition ISBN:

6 Approximate Total Costs Pharmacy Technician Program as of Spring 2015 Fee In-District Cost Out-of-District Cost General Service Fee Incidental Fee Tuition 1, , Lab Fees Insurance Background & Drug Screen Immunizations Books Uniforms TSBP Registration Estimated Total 3, , Dual Credit Student Track Pharmacy Technician (4PHAR) First Term PHRA 1301 Introduction to Pharmacy 3 PHRA 1305 Drug Classification 3 PHRA 1313 Community Pharmacy Practice I 3 Subtotal 9 Second Term HPRS 1206 Essentials of Medical Terminology 2 PHRA 1309 Pharmaceutical Mathematics I 3 PHRA 1349 Institutional Pharmacy Practice 3 Subtotal 8 Third Term PHRA 1347 Pharmaceutical Mathematics II 3 PHRA 1345 Compounding Sterile Preparations and Aseptic Technician *ACPE I.V 3 Certificate PHRA 1441 Pharmacy Drug Therapy and Treatment 4 Subtotal 10 Fourth Term PHRA 1360 Clinical- Community Pharmacy 3 PHRA 2360 Clinical- Institutional Pharmacy * 3 PHRA 1243 Pharmacy Technician Certificate Review 2 Subtotal 8 Certificate of Technology Total 35 *Capstone Experience Note: Student must pass each course listed in the certificate for Pharmacy Technician with a grade of C or higher to be eligible to receive a certificate of technology. Students must have all clinical requirements to be placed in clinical rotation. Transportation must be provided by the student to complete 160 unpaid clinical hours for each clinical course

7 Early College Track (This Track does not include High School or Associates Degree) Pharmacy Technician (4PHAR) No courses available HPRS 1206 Essentials of Medical Terminology 2 Subtotal 2 PHRA 1305 Drug Classification 3 PHRA 1313 Community Pharmacy Practice I 3 Subtotal 6 PHRA 1309 Pharmaceutical Mathematics I 3 Subtotal 3 PHRA 1441 Pharmacy Drug Therapy and Treatment 4 PHRA 1313 Community Pharmacy Practice I 3 Subtotal 7 PHRA 1347 Pharmaceutical Mathematics II 3 PHRA 1349 Institutional Pharmacy Practice 3 Subtotal 6 PHRA 1345 Compounding Sterile Preparations and Aseptic Technician *ACPE I.V Certificate 3 Subtotal 3 PHRA 1360 Clinical- Community Pharmacy 3 PHRA 2360 Clinical- Institutional Pharmacy * 3 PHRA 1243 Pharmacy Technician Certificate Review 2 Subtotal 8 Certificate of Technology Total 35 *Capstone Experience Note: Student must pass each course listed in the certificate for Pharmacy Technician with a grade of C or higher to be eligible to receive a certificate of technology. Students must have all clinical requirements to be placed in clinical rotation. Transportation must be provided by the student to complete 160 unpaid clinical hours for each clinical course