2025 Immunization Delivery Certification Program APhA Pharmacy-Based Immunization Delivery Certificate Program Cost: $350 for Wegmans School of Pharmacy Preceptors $400 for Pharmacists Contact InformationName * Required First Name Last Name Billing Address * Required Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Number * RequiredEmail Address * Required Current Position * Required Pharmacist WSOP Preceptor CPR Certification * Required Yes, I have a current CPR certificate No, I do not have a current CPR certificate Expiration Date of CPR Certification * Required MM slash DD slash YYYY I plan to become certified by: * Required MM slash DD slash YYYY Tuition: $350 Price: Tuition: $400 Price: Prework RequirementBy checking this box, I agree to complete the twelve hours of required prework by or before 5:00pm, May 9. Failure to complete these modules will remove me from this certification program. I am also aware that refunds are not available. I understand Δ
