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 seeking to register as pharmacy interns in Kansas. This guide aims to provide clear, step-by-step instructions to help users navigate the online application process effectively.

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

  1. Click ‘Get Form’ button to obtain the document and access it in an editable format.
  2. Complete the applicant information section, ensuring to fill out your first name, middle name, last name, date of birth, birthplace, and all contact information including your home and cell phone numbers.
  3. Provide your Social Security number as required, and include any other names used if applicable.
  4. Indicate your military status by checking the appropriate box and attaching the necessary documentation if claiming expedited review.
  5. List all colleges or universities attended, including current education, in chronological order, and indicate whether you graduated, alongside any degrees earned.
  6. State your employment plans by checking the relevant option regarding your work as a pharmacy intern.
  7. Detail any registration history with pharmacy-related licenses held in other states, providing the required documentation.
  8. Answer personal history questions accurately, as any misrepresentation can lead to denial of your application.
  9. If necessary, provide additional documentation for any yes answers to the questions in the personal history section.
  10. Read and understand the applicant certification statement. Then sign and date the form.
  11. If applicable, ensure the Dean or Registrar of your college fills out Part B and adds their signature along with the college seal.
  12. Once all sections are complete, save your changes, and you can download, print, or share the completed form as needed.

Start filling out the KS LA-03 online today!

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