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STATE BOARD OF PHARMACYREGISTRATION APPLICATION: Pharmacy Intern800 SW Jackson, Suite 1414 Topeka, Kansas 666121244 www.pharmacy.ks.gov (785)2964056 pharmacy ks.gov Fax (785) 2968420Form LA03INSTRUCTIONSAll.

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How to fill out the KS LA-03 online

The KS LA-03 form is essential for individuals applying for a pharmacy intern registration in Kansas. This guide provides a clear and supportive walkthrough to help you complete this form accurately and effectively.

Follow the steps to successfully complete the KS LA-03 online.

  1. Click ‘Get Form’ button to access the KS LA-03 and open it in your preferred online document editor.
  2. Begin by filling out your personal information under 'Part A: To be completed by applicant.' Include your first name, middle name, last name, and other requested personal details such as date of birth, birthplace, and contact information.
  3. Complete the section on military status. Indicate if you are a military member or their spouse and provide the necessary documentation, if applicable.
  4. Proceed to disclose your citizenship status. If you are not a U.S. citizen, remember to include supporting documents as specified.
  5. Fill in your post-secondary education details in chronological order, listing all educational institutions attended and any degrees earned.
  6. Complete the employment plans section. Indicate whether you are currently working or have been selected for a pharmacy intern position.
  7. In the registration history section, provide details of any prior registrations or permits held in other states, including any disciplinary actions that might have occurred.
  8. Answer the personal history questions honestly. These inquiries pertain to your past disciplinary actions and any legal issues that could affect your application.
  9. Review the applicant certification, ensuring you acknowledge the responsibilities and sign the document. Ensure the signature is dated.
  10. Collect all supplemental materials, including your government-issued ID, background check forms, and any necessary legal documentation for name changes. Ensure you enclose the application fee.
  11. Finally, review all information for accuracy, save your changes, and prepare the form for submission. You may choose to download, print, or share the completed application.

Complete your KS LA-03 form online today to take the next step towards your pharmacy internship.

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KS LA-03
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  • State Board Of Pharmacy: Pharmacist, Pharmacy Intern, AndState Board Of Pharmacy: Pharmacist
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