OUCOP/OCCC Assurance Program Application Survey

OUCOP/OCCC Early Assurance Program Application

Please fully complete the application to be considered for the OCCC Assurance Program at the University of Oklahoma College of Pharmacy. There is no specific due date but applications will not be reviewed until the completed application and supporting documents are received. Application decisions are emailed 2-4 weeks after completion. If you have questions, please reach out to Jennifer Richardson (jennifer-richardson@ou.edu) or by phone at 405-271-6598.

1.Contact Information(Required.)

First Name

Last Name

Preferred Name/Nickname

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Primary Phone Number

2.Are you a U.S. citizen or U.S. permanent resident? This is a requirement for eligibility and the PharmD program. Applicants must be a US Citizen or Permanent Resident at the time of application.

U.S. Citizen

U.S. Permanent Resident (green card holder)

3.High School Attended & Expected Graduation Date(Required.)

High School Attended

High School City/Town & State

Expected Graduation Date

4.Please list all colleges/universities attended, dates attended and the course(s) you received college credit for. Include the course name and number, your grade, and number of credits for the course(s). If you answered no, you may skip this question. PLEASE HAVE ALL OFFICIAL TRANSCRIPTS EITHER EMAILED TO: Jennifer Richardson (jennifer-richardson@ou.edu) or mailed via postal service to: OU College of Pharmacy, Attn: Jennifer Richardson, 1110 N Stonewall Ave, OKC, OK 73117.

5.If you have received grades for college courses, what is your current overall college GPA?

Please list the names and emails of the one reference you plan to provide for your application. Examples of a professional reference are teachers, professors, advisors, work supervisors, volunteer supervisors, etc. We do not accept references from clergy or family members.

To submit your reference, please send your reference the link below and have them complete the online form No other documentation is required from your references, but the form found here: https://www.surveymonkey.com/r/OCAPReference

Please reach out to Jennifer Richardson (jennifer-richardson@ou.edu) with any questions.

6.Enter your reference's first and last name and email. Do not forget to send them the reference link: https://www.surveymonkey.com/r/OCAPReference

First Name

Last Name

Reference Email Address

How do you know this reference? (Example: teacher, employer, etc.)

7.Please list any clubs, organizations, or activities you have been involved with.

8.Please list any honors, awards, or scholarships you have received.

9.Please list your employment/work history (if any) including where you were employed and your role (e.g. server, barista, lifeguard, etc) and the dates of employment. If currently employed, you can just say Date-Present.

Current Progress,

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