Military Service Credit Application

Instructions

Pursuant to Iowa Code section 272C.4, subsection 11, a military service applicant may apply for credit for verified military education, training, or service toward any experiential or educational requirement for pharmacist licensure, pharmacist-intern registration, or technician registration by submitting a completed Military Service Credit Application to the Board. Credit for military service may not be applied to an examination requirement. “Military service” means honorably serving on federal active duty, state active duty, or national guard duty, as defined in Iowa Code section 29A.1; in the military services of other states, as provided in 10 U.S.C. Section 101(c); or in the organized reserves of the United States, as provided in 10 U.S.C. Section 10101.

1. The application may be submitted prior to or with an application for licensure/registration. No fee is required with submission of an application for military service credit.

2. The applicant shall identify the experience or educational licensure requirement to which the credit would be applied if granted. Credit shall not be applied to an examination requirement.

3. The applicant shall provide documents, military transcripts, a certified affidavit, or forms that verify completion of the relevant military education, training, or service, which may include, when applicable, the applicant's Certificate of Release or Discharge from Active Duty (DD Form 214) or Verification of Military Experience and Training (VMET) (DD Form 2586).

4. Upon receipt of a completed military service application, the board shall promptly determine whether the verified military education, training, or service will satisfy all or any part of the identified experience or educational qualifications for licensure requirement.

5. The board shall grant the credit requested in the application in whole or in part if the board determines that the verified military education, training, or service satisfies all or part of the experience or educational qualifications for licensure.

6. The board shall inform the military service applicant in writing of the credit, if any, given toward an experience or educational qualification for licensure, or explain why no credit was granted.

7. The applicant may request reconsideration upon submission of additional documentation or information.

Address

Address or Location

Phone Number

Corresponding application type

Pharmacist

Pharmacist-intern

Technician

Please describe the experience or educational requirement to which your application applies.

Please identify the military education, training, or service you believe satisfies all or part of this requirement and attach below documents, military transcripts, a certified affidavit, or forms that verify completion of the relevant military education, training, or service, which may include, when applicable, the applicant’s Certificate of Release or Discharge from Active Duty (DD Form 214) or Verification of Military Experience and Training (VMET) (DD Form 2586).

Supporting files

Click Here to Upload

Additional files (as needed)

Click Here to Upload

Applicant's signature

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.