APhA-ASP/IPSF STUDENT EXCHANGE PROGRAM (SEP) PRE-APPLICATION

GENERAL INFORMATION

As a member of APhA-ASP and therefore, IPSF, any student pharmacist is eligible to apply for the Student Exchange Program (SEP). Please read the section on “Becoming an Exchange Student” in the document titled “How to Become Involved with SEP” before completing the application.

APPLICATION PROCESS

Complete sections I through VI of the pre-application. Only completed pre-applications submitted by the deadline will be considered. The deadline is November 1^st at 11:59 pm PST.

The APhA-ASP International Standing Committee (ISC) will notify selected applicants based on pre-applications by December 31^st. The pre-applications are scored based on a standardized rubric. Selected applicants will be instructed to complete the application on the IPSF website. There is no fee to submit a pre-application, but selected applicants will be required to pay a $65 fee, paid to APhA, to submit an application.

Do not apply on the IPSF website unless selected based on the pre-application and directed to by the Student Exchange Officer. Any student pharmacist who by-passes the pre-application process will be disqualified from participating in SEP.

STUDENT RESPONSIBILITIES

The student is responsible for his or her own travel expenses, transportation, costs of living, and telephone calls. All exchange students are responsible for their own documentation as well, including, but not limited to, proof of health insurance.

CONTACT INFORMATION

APhA-ASP International Standing Committee

APhA-ASP/IPSF Student Exchange Officer and Student Exchange Officer-elect: usaipsfseo@gmail.com

APhA Student Development Staff

apha-asp@aphanet.org

First Name *

Middle Name

Last Name *

APhA Member ID Number *

Gender *

Male

Female

SECTION I: GENERAL APPLICANT INFORMATION

School or College of Pharmacy *

Anticipated Year of Graduation *

APhA-ASP Chapter Advisor Name: *

APhA-ASP Chapter Advisor Email Address: *

Current Mailing (School) Address *

Current Mailing (School) Address 2

City *

State *

Zip *

Permanent (Home) Address *

Permanent (Home) Address 2

City *

State *

Zip *

Phone *

Alternate Phone

Email Address *

Languages Spoken Fluently *

Do you currently have an active passport? *

Yes

SECTION II

Section II: BACKGROUND AND EXPERIENCE

Limit your response to 500 words for each question.

Write a brief introduction about yourself, including the experience you have with IPSF and/or other cultures and why it qualifies you. Please do not rewrite your CV. It is an opportunity to expand on why you are an ideal candidate for SEP. (maximum 500 words) *

0/500 words

SECTION III

Section III: SHORT ESSAY

Please answer each of the following short essay questions. Limit your response to 200 words for each question.

Question 1. How would participating in SEP contribute to your future goals as a pharmacist? *

0/200 words

Question 2. If selected to participate in SEP, you will be a representative of APhA-ASP and the United States of America. Why are you an ideal representative? *

0/250 words

SECTION IV

Section IV: EXPERIENTIAL EDUCATION

Please write any experiential education (IPPE/APPE) that you must schedule or complete by September 15, 2025. Include the length of each. If none, please write N/A. Unless included on your pre-application, any scheduling conflicts related to experiential education will not release you from your responsibility to SEP and you will not receive a refund for the application.

Example of experiential education to schedule: “I must request my off-block by December 1^st, 2024.”

Example of experiential education to complete: “I must begin my APPEs in May 2025.”

SECTION V: LETTER OF INTENT AND CV/RESUME

Section V: LETTER OF INTENT AND CV/RESUME

Letter of Intent - Limit your response to 750 words.

Please include a letter of intent for why you would like to be selected to participate in SEP. (750 Word Limit)”? *

0/750 words

Please upload your CV/Resume in PDF format. *

SECTION VI: STATEMENT OF CONSENT

If selected, I agree to participate in the 2025 IPSF Student Exchange Program. I am aware of the responsibilities of the 2025 IPSF Student Exchange Program, including completing the application form on the IPSF website and submitting all payments and documents to APhA by the deadline. I will not hold APhA responsible for any liability in relation to my student exchange. I have completed this pre-application form to the best of my ability and knowledge. All statements on this form are true. I understand that any false statements or the failure to complete this application accurately may result in my disqualification from participation in the 2025 IPSF Student Exchange Program.

Signature of Applicant (please use your mouse or stylus to sign below): *

clear

Date Signed * +

SECTION VII: ADVISOR SUPPORT

In order for your pre-application to be considered complete, your chapter advisor must submit a letter of support/approval for you. Your letter of support/approval must uploaded via the following link: https://fs8.formsite.com/APhA-ASP/SEP_Advisor_LOR/index.html.

This letter should be no longer than one page in length. The letter should contain consent from your chapter advisor that you have their support/approval to apply.

SECTION VIII: ATTESTATION STATEMENT

I am attesting that I, have never been found guilty or pled guilty, regardless of the final outcome, to any charges, in any jurisdiction, regardless of whether those records have been expunged or sealed, related to harassment, intimidation, or abuse of power or position allegations, and I have not settled any such matters. Further, I am attesting that I have never been punished or disciplined in any matter related to harassment, intimidation, or abuse of power or position.

If you have any questions about this attestation please contact APhA General Counsel, Steve Benson, at sbenson@wtplaw.com.

Agree