Form #100-Q - Acknowledgement of Receipt of Application

This verifies that The Pharmacy Examining Board of Canada has received your Pharmacist Qualifying Examination application for:

Part I (MCQ) Fee of $__________

Part II (OSCE) Fee of $__________

From:

Name _________________________________________________________________

Address _______________________________________________________________

_______________________________________________________________________


Please complete the above information and include a self-addressed, stamped envelope (within Canada) or a self-addressed envelope and an International Postage Reply coupon (outside of Canada).

Please Note: Application receipt acknowledgement will NOT be provided by phone, fax or email.

Application received by PEBC on ________________________________ (to be completed by PEBC)


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