Application for Admission to Cooperative Pharmacy Program

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1 Cooperative Pharmacy Program University of Texas/Austin & El Paso Application for Admission to Cooperative Pharmacy Program Note: The application deadline has changed for INSTRUCTIONS (All High School applicants) 1. The Application for Admission to the high school pathway of the Cooperative Pharmacy Program must be submitted along with other application material before the deadline: a. A copy of your high school transcript. Please request that the transcript include your current GPA and estimated class ranking and results of standardized test scores (SAT or ACT). Please send or deliver a copy of an official transcript from the high school where you graduated or plan to graduate to the Cooperative Pharmacy Program Office at the address listed below. b. SAT or ACT score reports or test results including essay scores if not included on high school transcript.. c. The completed personal statement. d. Copy of current resume e. $60 non-refundable application fee made payable to The University of Texas at El Paso. (If payment is made by personal check, please include your driver s license number on your check.) f. Score reports (with letter grade of C or equivalent) for any credit earned by exam (Advanced Placement or International Baccalaureate). g. Indication of any dual credit coursework successfully passed. h. At least three letters of recommendation are required. Two of these letters should be from either a teacher or advisor who can attest to your ability to acquire new knowledge and apply critical thinking skills. 2. Application material may be mailed to the following address: Carmen Ramos, Program Coordinator Cooperative Pharmacy Program University of Texas at El Paso 500 West University El Paso, TX Application material may be delivered to our physical location Cooperative Pharmacy Program 1101 North Campbell Street Campbell Building, Rm 700 El Paso, Texas You may be invited for a personal interview. 5. High school applicants: The deadline date for receipt of all materials by the Cooperative Pharmacy Program is January 30, 2015 of your senior year in high school. 6. The Cooperative Pharmacy Program will acknowledge receipt of your application materials. 7. Please be sure your listed address is clearly legible. All application and interview information will be communicated via . Be sure to check your consistently after submitting your application.

2 REQUIREMENTS FOR ADMISSION TO THE SEQUENCE OF PROFESSIONAL COURSES Each student offered a position in the High School pathway of the Cooperative Pharmacy Program (CPP) will be required to satisfactorily complete all requirements of the program as listed in the Memorandum of Agreement that is signed by the student upon acceptance of the offer to become a student in the CPP. By the deadline date posted on the University of Texas at Austin College of Pharmacy s website ( ), each CPP student that wishes to begin their professional curriculum studies must submit an application to the PharmCAS application website ( ). Students in the CPP are responsible for all fees associated with the PharmCAS application. Following successful completion of the PharmCAS application, the CPP students will complete the second step of the UT College of Pharmacy application process and complete the supplemental on line application for the College of Pharmacy. High School pathway students in the CPP usually submit their PharmCAS application in the fall of their second or third year of the prepharmacy coursework at UTEP and the PharmCAS application is not required at the time of your high school application to the Cooperative Pharmacy Program. Students in the CPP apply to the University of Texas at Austin College of Pharmacy in the year that they are able to complete all prerequisite coursework by the conclusion of the spring semester. The prepharmacy prerequisite coursework required by the University of Texas at Austin College of Pharmacy maybe found on the College of Pharmacy website. ( In addition to completion of prepharmacy coursework, it is STRONGLY RECOMMENDED that any student desiring the Doctor of Pharmacy degree from the College of Pharmacy complete all core curriculum and flag course requirements of the University of Texas at Austin before beginning their professional curriculum. ( Core curriculum and Flag course requirements must be meet to receive a degree from the University of Texas at Austin.

3 Cooperative Pharmacy Program University of Texas/Austin & El Paso High School Pathway Application *An applicant must also apply for admission to the University of Texas at Austin the posted deadline of the year of entry into the College of Pharmacy. 1. I plan to start my pre-pharmacy coursework in: 2. Full legal name: Fall 20 (Last) (Maiden) (First) (Middle) (Suffix) 3. Date of Birth: Sex: Male Female 5. Residency 1 : a. Choose one of U.S. Citizen or International, and 6. Permanent Address: b. Choose one of: Legal Texas Resident Out-of-State The Cooperative Pharmacy Program does not process applications from International and Out of State applicants. International and Out of State applicants must apply directly to the College of Pharmacy following established procedures of the University of Texas at Austin College of Pharmacy. Non U.S. citizens who are legal Texas Residents must provide a copy of their Permanent Resident Alien Card (Street) (Unit #) (City) (State) (Zip Code) (Telephone) (County, if TX Resident or Country, if International Student) 7. Current Address: (Street) (Unit #) (City) (State) (Zip Code) (Daytime Telephone) (Evening Telephone) ( ) 8. Please send all correspondence to my: Permanent Address Current Address 1 UT-Austin Residency Regulations are used to determine your residency status for tuition purposes during pharmacy school. These may differ from those used by UTEP or other institutions. You are encouraged to confirm your residency status early in the application process. Information regarding residency regulations is available online at: and You may obtain a copy of: Appendix A: Residency Regulations from the UT-Austin General Information Catalog by contacting the Cooperative Pharmacy Program Office.

4 9. I have completed at least: 2 years high school foreign language or I plan to meet the requirement during my pre-pharmacy coursework 10. Work experience: Please list any work experience relevant to your application. If additional space is needed, attach a separate sheet or a résumé. (Please list most recent first.) Dates of Employment Job Title Employer Duties 11. Major extracurricular activities: Please list participation in activities and organizations during high school. Indicate the extent of your involvement, including any offices held. (Please list most recent first.) Activity Position Responsibility 12. Major Volunteer/Community Service activities (please list most recent first): Dates of Service Program/Organization Type of Experience 13. Honors or Awards (school or community; please list most recent first): 15. List ALL high schools and any colleges and universities you have attended. (Please list most recent first.) High School(s) and any Colleges Attended Months and Years Attended Date of High School Graduation

5 16. Senior Year Coursework Please indicate all coursework you are currently taking in your Senior Year. Place a check in the appropriate column to indicate if the course is PreAP, AP, IB, or Dual Credit. Name of Course Pre AP AP/IB Dual Credit 17. UTEP Scholarships Please indicate if you have been awarded a UTEP Scholarship ( for example, Presidential, Excellence, or Acacemic). Name of Scholarship

6 18. Please provide an official transcript from the high school where you graduated and transcripts from any colleges or universities awarding dual credits or other course credits, including UTEP. You may either enclose these with your application or have them mailed directly from the institutions attended. 19. Other than minor traffic violations, have you been convicted of or subject to deferred adjudication for a felony or misdemeanor? Yes No If yes, please state details of any such conviction or action on a separate piece of paper. An answer of yes is not in and of itself grounds for disqualification. Note: Similar questions will be asked on the internship card application issued by the Texas State Board of Pharmacy. Any past convictions appearing on a criminal history check may prohibit a student from gaining internship status with the Board of Pharmacy. If a student is not approved as an intern, he or she may not be able to complete academic requirements for graduation and, further, may not be eligible for licensure as a pharmacist in Texas. However, the Board of Pharmacy may grant limited internship status under certain circumstances to those with prior conviction. 19. I understand that the Admissions Committee does not regard applications as complete until all supporting documents have been received; therefore, it is in my interest to see that these documents are submitted as promptly as possible. I understand that transcripts must be submitted from the institution where I graduated high school and any colleges I have attended. I also understand that transcripts for any additional course work must be submitted at the end of each successive grading period (semester, quarter, etc.) for as long as my application is being considered and after acceptance. If you are denied admission to the high school pathway of the Cooperative Pharmacy Program and you wish to pursue a pharmacy degree in a subsequent year, you must reapply to both the University and the College, and you must meet all requirements in force at the time of reapplication. I certify that the information in this application is complete and correct, and I acknowledge that submission of any false information is grounds for rejection of my application, withdrawal of any offer of acceptance, or dismissal after enrollment. Signature of Applicant Date 16. Each applicant is required to submit to the Cooperative Pharmacy Program: 1) $60 non-refundable application fee payable to The University of Texas at El Paso; 2) personal statement; 3) high school transcript, including documentation of completion of foreign language requirement if completed in high school; high school transcript should include GPA and class ranking; 4) score reports for any credit earned by examination; 5) SAT or ACT score report; and 6) current resume. In addition, at least three letters of recommendation are required. Two of these letters should be from either your academic advisor or a teacher who knows you well. Letters of recommendation must be sent directly to the Cooperative Pharmacy Program from the recommender. Additionally, you may be asked to appear for a personal interview.

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