I.H.S. PHARMACY RESIDENCY 2010 APPLICATION CHECKLIST
Please complete items 1-11 below and mail the items together as one packet for each main “Area” where there are site(s) to which you are applying. In other words, to apply for sites in all of the Areas, you will need seven packets including seven transcripts, seven sets of references, etc. The application packet must be postmarked no later than midnight Saturday, January 9, 2010.
- Letter of Intent addressing why you wish to complete an I.H.S. Residency
- Completed IHS Residency Site Choices form (Excel - 33K)
- Curriculum Vitae – most current version at time of application
- Sealed transcripts from college of pharmacy – most current version
- Four sealed letters of reference utilizing form PHS-1813 (PDF)
- Form PHS-50 Application (PDF) for the USPHS Commissioned Corps
- Form BIA-4432 (PDF) (only if requesting consideration of Indian preference for employment)
- Declaration for Federal Employmentform OMB 3206-0182 (PDF)
- Addendum to Declaration for Federal Employmentform OMB 0917-0028 (Word)
- Completed Prospective Resident Survey (Word - 36K)
- Technical writing sample or presentation sample from your pharmacy school career
Email IHS Residency Site Selection (Excel - 31K) form to CAPT Cindy Smith (cindy.smith@ihs.gov)
If you have questions on the application process, they may be directed to CAPT Chris Watson
Acrobat
MS Word
