Application For Provisional Register Canadian University Students
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4Application for Provisional Register
Canadian University Students
Checklist
Signed copy of this checklist
Application form
Endorsed copy of one of the following:
(to endorse a copy, the guarantor writes, “I certify this is a true copy” on the document and signs the copy)
1. Canadian birth certificate
4. Canadian permanent resident Card
2. Canadian passport
5. Canadian work visa
3. Canadian citizenship card
Completed guarantor form – page 3. If using a commissioner for oaths, notary public or lawyer to endorse
documents this form is not required.
Original copy of criminal record check – not more than 6 months old. ACP recommends the use of BackCheck
for obtaining a criminal record check. Please use the following link ( )
to begin the process. Choose the Enhanced Police Information Check option as ACP will not accept
the Canadian Criminal Record Check only
A letter from a Canadian or U.S. university stating enrollment in a pharmacy degree program
1 endorsed passport sized photo.
(to endorse a photo, the guarantor writes, “I certify this is a true likeness” on the back of the photo and signs it)
2 letters of character reference. Letters of character reference must be written within the last 12 months and can
be written by anyone except family members. The letters should be written by someone who has known you for at
least one year. Letters must include the name, contact information and signature of the person providing the
reference; a statement about how long the person has known you and in what capacity they have known you; and
a statement about your character.
Copy of name change or marriage certificate – if name on any document is different from legal name.
Payment – see page 4 of the application
Once the application has been received in the ACP office allow 7 – 10 business days (not including
weekends) for processing. Due to volume ACP cannot confirm receipt of applications. You will
be advised via email once the application has been processed or if there are problems with the
application
I have reviewed this checklist and have included all required material with my application.
_______________________________________________
_____________________________
Applicant’s signature
Date
Alberta College of Pharmacists ■1100-8215 112 St. NW. Edmonton, AB T6G 2C8 ■Tel (780)990-0321 or (877)227-3838 ■ Fax (780)990-0328
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