Courses and Dates
Toronto Spring 2012 CPS I (Apr 23 - Jun 15, 2012)
Deadline for submission of Completed Application (and supporting documents including fluency): February 24, 2012
Fee Deadline: March 26, 2012
PART I - PERSONAL INFORMATION
Preferred Title: Mr. Miss Mrs. Ms Dr. Other (specify)
Legal Surname (last name)
Former Surname (if applicable)
Legal Given Name(s)
OCP Registration Number(if applicable)
PERMANENT HOME ADDRESS
(Provide FULL address – if applying from outside Canada include country)
Street Number: Street Name: Apt#:
City: Province/State:
Country: Postal Code:
Phone Number at this address (include area code):
MAILING ADDRESS
(Address to which you would like all correspondence sent if different from permanent address)
Is your mailing address the same as above? Yes No
E-MAIL ADDRESS
STATUS IN CANADA
Canadian Citizen Landed Immigrant
Student and/or Employment, or Visitor Visa - Expiry date
Academic Institution Attended:
Country:
Year of Graduation:
PART II - ADMISSION REQUIREMENTS
You are required to complete the following sections for admission to the IPG Program.
1. FLUENCY
Have you Achieved Fluency in English or French? Yes No
Note: It is your responsibility to notify the fluency testing centre to forward your test results directly to the IPG Program and the Ontario College of Pharmacists (if you are opening a file with the OCP). Fluency results must be no more than 2 years old from the end date of the CPS program. Please ensure that you have an updated fluency test.
2. PHARMACY EXAMINING BOARD OF CANADA EVALUATING EXAM
Pass - Month: Year:
Not Yet Complete - Month: Year:
(Please indicate the intended date of completion)

3. PHARMACY EXAMINING BOARD OF CANADA QUALIFYING EXAM
How many times have you attempted Part I of the PEBC Qualifying Exam?
How many times have you attempted Part II of the PEBC Qualifying Exam?
Note: If you have attempted Part I and/or Part II four or more times, a copy of the PEBC letter stating eligible to attempt the Qualifying Exam must be provided for admission to the IPG program.
PART III - CONSENT
By clicking "Submit Information" I hereby certify that:
  • All information contained in this application is correct and complete.
  • The name shown at the top of the application is the complete name by which I am legally and correctly known.
  • I consent that the IPG Program will provide my name and verify the admission requirements of identity, status, Fluency and PEBC Evaluating Examination results with, as well as provide course results to, the Ontario College of Pharmacists or other relevant provincial regulatory College.
Any misrepresentation of this data may result in cancellation of my application, admission or registration to the IPG Program.
Payment Options
I wish to pay by:
Credit Card Certified Cheque