School of Pharmacy
School of Pharmacy
2300 MacCorkle Avenue
Charleston, WV 25304
304-357-4889
Fax:  304-357-4868 

School of Pharmacy Application & Fee Payment

Please complete the School of Pharmacy application below. A non-refundable $50 application fee is required!

General Applicant Information

First Name


Middle Name

Last Name

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Maiden Name

PharmCAS ID

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Email

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Current Address Information

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Home Phone

Cell Phone

Daytime Phone


Permanent Address Information

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Address


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Billing Information

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Check if your PERMANENT address is the same as your billing address.  

To complete your secure online payment, please enter your billing information below. The billing information should be exactly as it appears on your credit card statement.

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Method of payment

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