Itpd Professional Sponsor Form

International-Trained PharmD (ITPD) Program
PROFESSIONAL SPONSORSHIP FORM

University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences
Each applicant will need to submit a completed professional sponsor form. The professional sponsor (typically an employer), will need
to attest to their support of the candidate’s pursuit of the degree program, and the applicant’s plans for expanding the practice of
patient-centered pharmacy care outside the United States. The professional sponsor completing the form should be located in the
applicant’s home country or the country in which they intend to practice pharmacy (outside of the U.S.). This sponsorship does not
require financial sponsorship. If your professional sponsor is also serving as a reference they must be added to the online application as
a recommender and complete the online letter of recommendation form. Professional Sponsorship Letters submitted in lieu of this
form will not be accepted.
TO BE COMPLETED BY THE APPLICANT:
Applicant:_______________________________________________ Date:______________________________________________
Complete Name
Address:_________________________________________________ Phone:____________________________________________
Street
________________________________________________________ _________________________________________________
City, State, Zip, Country Passport Number (for tracking purposes)
WAIVER OF RIGHT OF ACCESS TO LETTER OF REFERENCE

The applicant must complete the following statement before submitting the form to the sponsor. This request follows Federal Law P.L. 93-380
(Family Education and Privacy Act of 1974).
Professional Sponsorship Form is confidential. I hereby voluntarily waive any right of access to this form.
Professional Sponsorship Form is not confidential. I do not waive my right of access.
_________________________________________________________ _________________________
Applicant Signature Date
TO BE COMPLETED BY THE PROFESSIONAL SPONSOR:

The individual above has applied for admission to the University of Colorado School of Pharmacy. Your sponsorship is critical to our
admission process. We request that you make every effort to respond objectively to our questions regarding this individual. We
request that you provide us with some thoughtful feedback on the applicant’s ability to expand patient centered pharmacy outside of
the United States.
You may send a letter or statement in addition to this form; however, we require that you also complete the following sections. After
you complete the form, please email directly to the Distance Degrees and Programs office at pharmacy.online@cuanschutz.edu .
Thank you for your assistance.
YOUR REALTIONSHIP TO THE APPLICANT
How well do you know the applicant? Not well acquainted Slightly Fairly Well Very Well
How long have you known the applicant?__________________________________
What is your relationship to the applicant?___________________________________________________________________
Please describe how you are qualified to be this applicant’s sponsor._______________________________________________

APPLICANT’S INTEREST IN THE ITPD PROGRAM
• What is your assessment of the applicant’s interest in obtaining a PharmD from the University of Colorado Skaggs School of
Pharmacy and Pharmaceutical Sciences?
APPLICANT’S PLAN FOR EXPANDING THE PRACTICE OF PATIENT-CENTERED PHARMACY CARE

• Describe the applicant’s plan to advance pharmacy’s role in patient-centered care outside of the U.S.
• What is your role in ensuring the applicant achieves their plan to advance pharmacy’s role in patient-centered?
Professional Sponsor’s Name:________________________________________ Position:___________________________________
Address:____________________________________________________________________________________________________
Professional Telephone
Number:_________________________________________________________________________________
Professional Email:___________________________________________________________________________________________
Signature:_______________________________________________________________ Date:_____________________________
Please email the completed form directly to the Distance Degrees and Programs office at
pharmacy.online@cuanschutz.edu Forms will only be accepted from professional email addresses
matching the email address listed above.

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International-Trained PharmD (ITPD) Program

PROFESSIONAL SPONSORSHIP FORM

TO BE COMPLETED BY THE APPLICANT:

WAIVER OF RIGHT OF ACCESS TO LETTER OF REFERENCE

TO BE COMPLETED BY THE PROFESSIONAL SPONSOR:

YOUR REALTIONSHIP TO THE APPLICANT

How long have you known the applicant?__________________________________

What is your relationship to the applicant?___________________________________________________________________

Please describe how you are qualified to be this applicant’s sponsor._______________________________________________

APPLICANT’S PLAN FOR EXPANDING THE PRACTICE OF PATIENT-CENTERED PHARMACY CARE

Professional Sponsor’s Name:______ Position:_

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