Steven W. Schierholt, Esq.
John R. Kasich
Executive Director
Governor
Veteran Workforce Verification Form – Pharmacy Technicians
Upload the completed form and attachments as a single PDF file to:
Definition of a Veteran: "Veteran" means anyone who is serving or has served under honorable
conditions in any component of the armed forces, including the national guard and reserve.
Definition of Armed Forces: "Armed forces" means the armed forces of the United States,
including the army, navy, air force, marine corps, coast guard, or any reserve components of those
forces; the national guard of any state; the commissioned corps of the United States public health
service; the merchant marine service during wartime; such other service as may be designated by
congress; or the Ohio organized militia when engaged in full-time national guard duty for a period
of more than thirty days.
First Name
Last Name
Social Security Number
Email Address
Military Service Branch (select one)
Service Start Date:
Service End Date (if applicable):
Air Force Reserve
Please include the following documentation with this form to obtain an application fee refund and
renewal fee waiver:
For an Honorably Discharged Veteran: Applicant must submit an unedited ("long") copy of a
DD-214 form.
For an Active Duty Veteran: Applicant must submit one of the following:
1. A letter from the individual's commanding officer (on letterhead) certifying that the
applicant is on active duty status;
2. A copy of the most recent permanent change of station orders; or
3. Active duty orders.
IMPORTANT! This form and the documentation listed above MUST be submitted as one
PDF (Adobe Acrobat Format) document. For more information on submitting this
documentation, please review the appropriate application instructions on the pharmacy
technician page:
77 South High Street, 17th Floor, Columbus, Ohio 43215
T: (614) 466.4143 | F: (614) 752.4836 | contact@pharmacy.ohio.gov |