Our Story

Name *

Email *

Phone *

Are you male or female? *MaleFemale

Are you 18 years of age or older? *You may still apply if your under 18 years of age. However, you must be over the age for compulsory attendance in your state to receive a scholarship.YesNo

Do you have a HS diploma or GED? *YesNo

Do you have a US State ID? *Example: Drivers License or Social Security CardYesNo

Are you able to pass a DPS (Department of Public Safety) background check? *One of the requirements to receive an award is to obtain a Fingerprint Clearance Card which requires a DPS background check.YesNo

Have you ever applied for a Fingerprint Clearance Card and been denied? *YesNo

Do you require financial assistance to help with the cost of your tuition or student loans? *YesNo

Have you already applied to the school of your choice? *One of the requirements to receive an award is to apply for funding through the school where you want to attend.YesNo

What school are you trying to attend ? *Arizona's Virtual Pharmacy Tech SchoolArizona Western CollegeNorthern Arizona UniversityGateWay Community CollegeMy choice is not listed

Do you require any special accommodations that is qualified under the ADA to complete your program? *YesNo

Which Scholarship are you applying for? *Gold ScholarshipScholarshipBronze Scholarship

Are you unemployed? *YesNo

Select the appropriate box that identifies your current annual income. *An individual who makes $15,650 or lowerI have a family of 2 who makes 21,150 or lowerAn individual who makes 16,000 - 25,000 per yearAn individual who makes between 25,000 - 40,000 per yearI make over 40,000 per year

Please upload a copy of your State ID and high school transcript. *Your application will be marked incomplete without both documents.

No file chosen

Consent *

AZOPTA (Arizona Online Pharmacy Tech Association) will use the information you provided to conduct a background check to determine the validity of your application.

Home
About
Services
Contact
Our Team