The Pharmacist by Examination or Score Transfer Application is the form every new pharmacist must file with the New Jersey Board of Pharmacy to get licensed and start working in the state. It tells the Board who you are, proves you finished pharmacy school, confirms your hours of training, and clears you to sit for the two exams every New Jersey pharmacist must pass. You file it under the rules set in N.J.A.C. 13:39-2.1, the chapter that governs pharmacist licensing.
Getting this form wrong is costly. The Board states plainly that incomplete applications will be returned, and a returned application can push your start date back by weeks. New Jersey licenses thousands of pharmacists, and the licensure application fee alone is $125 and is nonrefundable, so a mistake here means lost money and lost time. This guide walks you through the form one line at a time so you file it right the first time.
Here is what you will learn:
- 📋 What the form is, who must file it, and which version applies to you
- 🗂️ Every document and ID number you must gather before you start
- ✍️ A line-by-line walkthrough of each box, with sample entries and the mistakes that trip filers up
- 🧑⚕️ Three full real-world examples that follow named applicants from start to finish
- 📮 How to file by mail or online, what it costs, and how to track your approval
What the Form Is and Who Must File It
The Pharmacist by Examination or Score Transfer Application is the official request you send to the New Jersey Board of Pharmacy to become a licensed pharmacist. The Board reviews it, confirms you meet the education and training rules in N.J.A.C. 13:39-2.1, and then clears you to take the NAPLEX and MPJE exams or to transfer scores you already earned. Without an approved application, you cannot test, and without passing scores, you cannot hold a license.
The Board is the agency that receives the form. It sits inside the New Jersey Division of Consumer Affairs and exists to protect the public by confirming every pharmacist has met the legal requirements. The statute behind the Board’s power is found in N.J.S.A. 45:14, and the detailed rules live in N.J.A.C. 13:39. These rules set the fee, the training hours, and the documents you must attach.
You must file this form if you are a recent graduate of an ACPE-accredited pharmacy school, a foreign pharmacy graduate, or an out-of-state pharmacist transferring exam scores rather than reciprocating a full license. The Board states that all other applicants seeking licensure who do not qualify for reciprocity should use this exact form. The plain-English point is simple: if this is your first New Jersey pharmacist license and you have not been actively practicing 1,500 hours in the past two years in another state, this is your form.
A related form is the Pharmacist by Reciprocity Application. The Board limits reciprocity to applicants who hold an active pharmacist license in good standing, without any restrictions, in another state and who practiced at least 1,500 hours in the prior two years, under N.J.A.C. 13:39-2A.1. If you do not meet that bar, the examination or score transfer route is your path. Choosing the wrong form is the first major mistake filers make, and it leads to a flat rejection.
| Pharmacist by Examination or Score Transfer | Pharmacist by Reciprocity |
|---|---|
| For new grads, foreign grads, and score transfers | For active out-of-state pharmacists in good standing |
| Governed by N.J.A.C. 13:39-2.1 | Governed by N.J.A.C. 13:39-2A.1 |
| No prior practice hours required from another state | Requires 1,500 practice hours in the past two years |
| You take or transfer NAPLEX and MPJE scores | You transfer an existing active license |
Before You Start: Documents and Information You Need
Gather everything before you open the form. The Board returns incomplete packets, so a missing item is the difference between a four-week approval and a three-month delay. Pull these together first:
- A copy of your birth certificate. The Board requires a legible copy with the application to confirm your identity and date of birth. Without it, your packet is incomplete and gets sent back.
- Your Social Security number. The Board warns that failure to provide your Social Security number will result in denial of registration. There is no workaround, so have the card or number ready.
- Proof of immigration status if you are not a U.S. citizen. You must attach a copy of the front and back of your alien registration card or other USCIS documentation. Missing this stalls a non-citizen’s file.
- An official transcript from an ACPE-accredited pharmacy school. Your school must send this straight to the Board, showing your graduation date and degree. The Board cannot approve you to test without it.
- FPGEC certification if you are a foreign graduate. Graduates of non-ACPE schools must show certification from the FPGECC instead of a U.S. transcript. Skipping this blocks foreign applicants entirely.
- Proof of your internship hours. New Jersey requires supervised practice hours, and foreign graduates must show a 1,440-hour internship. Hours that are not documented do not count.
- A 2”x2” passport-style photograph. It must be full-face, head and shoulders, and taken within the past six months. The Board says do not staple it, or it may be rejected.
- A check or money order for the fees. Make it payable to the State of New Jersey for the $125 application fee plus the criminal history background check fee. Cash and personal e-payments by mail are not accepted.
- Documentation of any name change. If your current name differs from your birth certificate, you must include a marriage license, marriage certificate, or court judgment. A name mismatch without proof triggers a hold.
- Your NAPLEX and MPJE score notifications, if transferring. Score-transfer applicants must include notification of passing New Jersey scores. Without them, the Board has nothing to verify.
Having each item in hand means you fill the form in one sitting and mail a complete packet. A missing ID number or unsent transcript is the single most common reason applicants wait months instead of weeks.
Where to Get the Form and How to Access It
You get the official form from the Board of Pharmacy applications page on the New Jersey Division of Consumer Affairs website. Look for the link labeled Pharmacist by Examination or Score Transfer Application. The Board posts the current version there as a downloadable PDF, along with a matching set of registration instructions that mirror the steps in this guide.
Always download the form fresh from the Board’s site rather than using a copy a friend sent you. The Board updates forms and fee schedules over time, and an outdated version can list the wrong fee or leave out a required question. Check the revision date printed on the form against the version on the Board page so you know you have the current one.
The form is also tied to the MyLicense online portal, which the Board uses for renewals, reinstatements, and many uploads. New first-time pharmacist applicants generally complete the paper application and mail it, while later actions such as renewal and the hormonal contraceptive affirmation happen inside MyLicense. Print the PDF single-sided so the notary and the Board can read every page, and keep a full copy of what you send.
If you plan to take the exams, you also register separately with the National Association of Boards of Pharmacy through an NABP e-Profile to schedule the NAPLEX and MPJE. The Board application and the NABP registration are two different steps, and you need both. The Board clears you to test; NABP delivers the exams.
Step-by-Step: How to Fill Out the Pharmacist by Examination or Score Transfer Application Line by Line
Work through the form in the exact order the pages appear. Use black ink, print clearly, and answer every question, because the Board returns any packet with blank required fields. Below, each section gets its own walkthrough.
Personal Information: Name
This section asks for your full legal name. Write your first, middle, and last name exactly as they appear on your birth certificate and Social Security card, because the Board cross-checks these records and a mismatch triggers a hold. Use your legal name, not a nickname or shortened form.
For example, Priya Anjali Sharma writes her name in full rather than Priya S. If your name has changed since birth, you still write your current legal name here, but you must attach proof of the change. A common edge case is a hyphenated last name after marriage, which you write out in full as it now appears on your ID.
The most common mistake here is using a name that does not match your transcript or Social Security record, which forces the Board to pause your file while it sorts out the difference. A misconception filers hold is that the name on the form is just a label and any version is fine; in reality, every document in your packet must carry the same legal name, or the Board cannot verify you.
Personal Information: Birthdate and Place of Birth
This field asks for the date and place you were born. Enter your birthdate in the format the form shows, and name the city, state, and country of your birth. You must include a copy of your birth certificate with the application to back up these entries.
For example, Priya Anjali Sharma writes her birthdate and lists Edison, New Jersey, USA as her place of birth, then clips a copy of her birth certificate to the packet. If you were born outside the United States, you still list your true place of birth and attach your birth certificate or an equivalent record. A translated copy is wise if the original is not in English.
The common mistake is forgetting to attach the birth certificate at all, which the Board treats as an incomplete application and returns. The misconception is that listing the date is enough on its own; the Board needs the certificate as proof, so the box and the document work together.
Personal Information: Home, Business, and Mailing Address
This section asks where you live, where you work, and where you want mail sent. Fill in your current home address, your business address if you have one, and the mailing address where the Board should reach you. Keep the mailing address current, because this is where approval notices and any request for missing items will go.
For example, Priya Anjali Sharma lists her apartment as her home address and writes the same address as her mailing address since she has no separate business location yet. If you use a P.O. Box, you may list it as the mailing address, but provide a physical home address too. Students about to move after graduation should use an address that will stay valid for several months.
The common mistake is listing an address you are about to leave, so the Board’s notice arrives after you have moved and you miss a deadline to fix your file. The misconception is that the Board emails everything; many notices still go by mail, so an outdated address can quietly sink your application.
SSN and Citizenship / Immigration Status
This section asks for your Social Security number and your citizenship or immigration status. Write your full Social Security number, then check the box that fits you: U.S. citizen, lawful permanent resident, or another immigration status. The Board is direct that failure to provide your Social Security number will result in denial of registration.
For example, Priya Anjali Sharma, a U.S. citizen, writes her nine-digit Social Security number and checks the citizen box. An applicant who is a permanent resident checks that box instead and attaches a copy of the front and back of the alien registration card. A non-citizen with another status attaches the matching USCIS documentation.
The common mistake is leaving the Social Security field blank out of privacy concern, which guarantees a denial under the Board’s own rule. The misconception is that immigration status alone bars you from licensure; lawful residents and others with valid status can be licensed as long as they document that status correctly.
Medical Conditions (Questions a–f)
This section asks a set of health questions, labeled a through f, about conditions that could affect safe practice. Answer each one by checking Yes, No, or Not Applicable. If you answer Yes to question f, you must note whether you currently take part in a rehabilitation program, as the form details, then sign and date at the lines given.
For example, Marcus Lee checks No to questions a through e and Yes to f, then notes that he is active in a monitored recovery program and signs and dates the section. If a condition is treated and controlled, you still answer honestly and explain on the lines provided. Honesty paired with proof of treatment is what the Board looks for.
The common mistake is skipping a sub-question because it feels personal, which leaves the section incomplete and gets the packet returned. The misconception is that a Yes answer automatically blocks licensure; the Board reviews context and active treatment, so an honest answer with documentation often clears review.
Additional Circumstances (Questions 8 and 9)
This section asks about specific legal circumstances in questions 8 and 9. Answer each by checking Yes or No based on whether the described situation applies to you. If you answer Yes to question 9, you must attach a copy of the judgment of conviction, your release from parole or probation, and a full written explanation on extra sheets filed with the application.
For example, Marcus Lee checks No to question 8 and Yes to question 9, then attaches his court judgment, his probation release papers, and a typed letter explaining the event and what he has done since. If your record was expunged, you still read the question carefully and answer based on its exact wording. When in doubt, disclose and explain rather than hide.
The common mistake is checking Yes but failing to attach the required judgment and explanation, which stalls the file while the Board requests the missing papers. The misconception is that a past conviction always ends the process; the Board weighs the full record, and a clear, documented explanation often allows approval.
Other License, Certificate, Permit, or Registration
This section asks whether you now hold, or have ever held, a professional license, certificate, permit, or registration in any state or country. Check the box that applies. If any credential was issued under a different name, provide that name, and list the dates held and the number for each one.
For example, David Okafor, who is transferring scores from another state, checks Yes, lists his prior state license number, and gives the dates he has held it. If you held a license under a maiden name, you write that name in the space provided so the Board can match the record. List every credential, even expired ones.
The common mistake is leaving off an old or inactive license, which can look like concealment when the Board’s national checks reveal it. The misconception is that only pharmacy licenses count; the question covers any professional credential, so a prior license in another field belongs here too.
Additional Circumstances (Questions 11–17)
This section asks questions 11 through 17 about further legal and disciplinary circumstances. Answer each with Yes or No based on whether the statement describes you. If you answer Yes to any of them, attach a letter with your application explaining the circumstances of the action that led to your Yes answer.
For example, David Okafor checks No to most items but Yes to one about a prior board inquiry in another state, then attaches a letter describing what happened and how it was resolved. Read each statement slowly, since these questions cover actions like discipline, denial, or settlement that you might not think of as relevant. A short, factual letter is enough.
The common mistake is rushing and checking No to all without reading, then having the Board find an undisclosed action that now looks dishonest. The misconception is that minor or out-of-state matters do not count; the questions are broad, so disclose anything that fits and let your letter give the context.
Education (Questions 1–3)
This section asks about your schooling. Complete questions 1 through 3 with your high school name, address, years attended, and graduation status, plus any GED record. Then, if it applies, list the college or university you currently attend, and list every degree you have earned from recognized colleges. To be approved for the NAPLEX and MPJE, you must have your school forward an official transcript showing your graduation date and the degree conferred.
For example, Priya Anjali Sharma lists her high school, then her PharmD from an ACPE-accredited program, and asks her registrar to mail her official transcript straight to the Board. Foreign graduates list their overseas pharmacy degree and rely on FPGECC certification in place of a U.S. transcript. The transcript must come from the school, not from your own hands.
The common mistake is assuming a transcript you carry in yourself counts; the Board needs it sent directly from the school, or it does not accept it. The misconception is that listing the degree on the form is enough; the form entry and the official transcript are two separate requirements that both must arrive.
Affidavit (Notarized)
This section is a sworn statement you must complete before a notary public. Fill in the state and county in the first two blanks, write your name where indicated, and sign at the signature line. The affidavit must be signed, dated, and stamped with the notary’s seal to be valid.
For example, Marcus Lee takes the unsigned form to a bank notary, fills in New Jersey and Essex for state and county, prints his name, then signs only in front of the notary who applies the seal. If you sign before reaching the notary, many notaries make you sign again, so wait. A notary at a bank or shipping store can usually do this for a small fee.
The common mistake is signing the affidavit at home and mailing it without a notary seal, which makes the whole application invalid and sends it back. The misconception is that any witness will do; only a commissioned notary public can complete this section, and the seal is what gives it legal weight.
Certification and Authorization for a Criminal History Background Check
This section authorizes the Board to run a criminal history check. Complete the personal information in questions 1 through 4, then record whether you have completed fingerprinting for the NJDCA since November 2003, with details if you have. There is a separate fee for the background check, paid by check or money order to the State of New Jersey, and you must answer question 6 about arrest and conviction records and submit any documents it requires.
For example, David Okafor fills in his personal details, notes that he was fingerprinted for a prior New Jersey credential after 2003, and includes the background check fee. If you have never been fingerprinted in New Jersey, you follow the form’s instructions to schedule it through the state’s vendor. Keep the receipt as proof.
The common mistake is forgetting the separate background check fee and assuming the $125 covers it, which leaves the check unpaid and the file incomplete. The misconception is that an old out-of-state background check satisfies New Jersey; the Board runs its own check and needs this authorization signed.
Certification (Final Signature)
This final section is your signed promise that everything in the application is true. Print your full name in the first blank, then sign and date the certification at the bottom of the statement. This signature ties you to every answer above it.
For example, Priya Anjali Sharma prints Priya Anjali Sharma, signs in ink, and dates it the day she mails the packet. Sign only after you have checked every page and attached every document, since your signature certifies the file is complete and accurate. Do not pre-date or post-date this line.
The common mistake is leaving this signature blank, which voids the entire application no matter how perfect the rest is. The misconception is that the notarized affidavit covers this too; they are separate signatures, and the Board needs both.
Three Filled-Out Examples Using Real Scenarios
Below are three common applicants who each follow the form from start to finish. Their entries show how the same form fits different paths.
Scenario 1: Priya, a new ACPE-accredited PharmD graduate
| Form Section | What Priya Enters |
|---|---|
| Full legal name | Priya Anjali Sharma, matching her Social Security card |
| Birthdate and place of birth | Her birthdate and Edison, New Jersey, USA, with birth certificate attached |
| SSN and citizenship | Her full SSN; checks U.S. citizen |
| Medical conditions a–f | Checks No to all, signs and dates |
| Education | Lists her ACPE-accredited PharmD; school mails official transcript |
| Affidavit | Signs before a notary who seals it |
| Background check | Completes fingerprinting, pays the separate fee |
| Fees and photo | Encloses a $125 check to State of New Jersey and a 2”x2” photo, unstapled |
Scenario 2: Wei, a foreign pharmacy graduate
| Form Section | What Wei Enters |
|---|---|
| Full legal name | Wei Chen, matching passport and FPGEC record |
| SSN and citizenship | Full SSN; checks lawful permanent resident, attaches green card copies |
| Education | Lists overseas pharmacy degree |
| Foreign credential proof | Submits FPGECC certification in place of a U.S. transcript |
| Internship | Documents the required 1,440-hour internship |
| Affidavit | Completes and notarizes the sworn statement |
| Exam scores | Includes notification of passing NAPLEX and MPJE |
| Fees and photo | Encloses the $125 fee, background check fee, and a recent 2”x2” photo |
Scenario 3: David, an out-of-state pharmacist transferring scores
| Form Section | What David Enters |
|---|---|
| Full legal name | David Okafor, matching all records |
| Other licenses held | Checks Yes, lists prior state license number and dates |
| Additional circumstances 11–17 | Discloses a prior board inquiry, attaches an explanation letter |
| Education | Lists his U.S. PharmD; school forwards transcript |
| Score transfer | Submits notification of passing NAPLEX and MPJE scores for New Jersey |
| Background check | Notes prior NJ fingerprinting, pays the fee |
| Affidavit | Signs and notarizes |
| Certification | Prints name, signs, and dates the final line |
How to File the Completed Form
The primary channel is by mail. The Board directs you to mail the completed, notarized application with the photograph attached to: Board of Pharmacy, 124 Halsey Street, 6th Floor, Newark, NJ 07102. Include a check or money order payable to the State of New Jersey for the nonrefundable $125 application fee, plus the separate criminal history background check fee. Use a trackable mail service so you have proof of delivery, and keep a full copy of everything you send.
For the fingerprinting step, you schedule a separate appointment through the state’s identification vendor as the background check form directs, and you pay that fee at the time of service. Keep the fingerprint receipt, because it is your proof the step is done. The transcript and any FPGEC certification travel on their own paths, sent directly by your school or by the FPGECC to the Board.
The MyLicense portal at newjersey.mylicense.com handles online actions such as renewals, reactivations, and uploads like the hormonal contraceptive affirmation. First-time applicants generally file the paper packet, then use MyLicense afterward to manage the license. Once licensed, your renewal runs on a two-year cycle, and the biennial renewal fee is $140.
For proof of filing, keep your mailing receipt, the cancelled check or money order stub, the fingerprint receipt, and a photocopy of the full application. These records let you prove what you sent and when if the Board ever says something is missing. Review the whole packet for accuracy before mailing, because the Board returns incomplete applications and that delays everything.
What Happens After You File
After the Board receives your packet, it reviews your file for completeness and confirms your education, hours, and background. If anything is missing, the Board returns the application or mails a request for the missing item, which is why a current mailing address matters so much. A complete, clean packet moves faster than one that forces back-and-forth.
Once your application is approved, the Board clears you to take the NAPLEX and MPJE through your NABP e-Profile, or it accepts the passing scores you transferred. You schedule and sit for the exams, and your passing scores flow back to the Board. The Board cannot issue a license until it has both an approved application and passing scores on file.
When both pieces are in place, the Board issues your pharmacist license, and you can begin practicing in New Jersey. From there, you manage the license inside MyLicense, where you handle the biennial renewal and your continuing education records. Keep your contact information current in the portal so renewal notices reach you on time.
Mistakes to Avoid When Filling Out the Form
- Using the wrong form. Filing reciprocity instead of examination, or the reverse, leads to a flat rejection and a fresh start.
- Leaving the Social Security field blank. The Board denies registration outright when the SSN is missing.
- Forgetting the birth certificate copy. A missing certificate makes the packet incomplete and gets it returned.
- Signing the affidavit before reaching a notary. An unsealed or improperly signed affidavit voids the application.
- Stapling the photograph. The Board says not to staple it, and a damaged or wrong-size photo can be rejected.
- Paying only the $125 fee. The criminal background check carries a separate fee, and skipping it leaves the file incomplete.
- Carrying in your own transcript. The Board only accepts transcripts sent directly from the school.
- Listing a name that does not match your records. A mismatch with your SSN or transcript triggers a processing hold.
- Checking “Yes” without attaching the explanation. A disclosure with no judgment, letter, or documents stalls review.
- Using an outdated mailing address. Notices sent to an old address can cause you to miss a deadline to fix your file.
- Skipping a sub-question in the medical or circumstances sections. Any blank required field gets the packet returned.
- Forgetting the final certification signature. An unsigned certification voids the entire application.
Do’s and Don’ts
Do:
- Do download the form fresh from the Board page so you have the current version and fee.
- Do gather every document before you start so you can file a complete packet in one mailing.
- Do match every name across your form, SSN, and transcript so the Board can verify you without delay.
- Do sign the affidavit only in front of a notary so the seal makes it valid.
- Do mail with tracking and keep copies so you can prove what you sent and when.
- Do disclose any legal or board history honestly so the Board sees candor rather than concealment.
Don’t:
- Don’t leave any required field blank because the Board returns incomplete applications.
- Don’t staple the photograph since the form warns against it.
- Don’t assume one fee covers everything because the background check is billed separately.
- Don’t hand-carry your transcript because only school-sent transcripts are accepted.
- Don’t hide a past conviction or license action because national checks reveal it and concealment hurts more.
- Don’t mail an unsigned or unnotarized packet because both signatures are required.
Pros and Cons of Filing on Your Own vs. With Help
Most applicants file this form themselves, but some use a school advisor or an attorney for tricky records. Weigh the trade-offs below.
Pros of filing on your own:
- You save money since you pay only the Board’s fees and no advisor cost.
- You control the timeline and can mail the moment your documents arrive.
- You learn your own record by reading each question closely.
- The form is well documented through the Board’s official instructions.
- Direct contact with the Board keeps answers coming straight from the source.
Cons of filing on your own:
- You carry the full risk of a returned packet if you miss a field.
- Legal disclosures are hard to word without guidance on questions 9 and 11–17.
- Foreign credential rules are complex and easy to misread without help.
- You track every separate piece like the transcript, fingerprints, and fees alone.
- A small error costs weeks, and the $125 fee is nonrefundable.
FAQs
Do I have to provide my Social Security number on the application?
Yes. The Board states that failure to provide your Social Security number results in denial or nonrenewal of registration, so there is no way to leave it blank.
Do I write my maiden name or my current name in the name field?
No. You write your current legal name, but if a credential was issued under your maiden name, you list that prior name where the form asks and attach proof of the change.
Do I need to staple my photograph to the application?
No. The Board specifically says do not use staples; attach the clear 2”x2” full-face photo taken within the past six months by another method.
Do I have to get the affidavit notarized?
Yes. The affidavit must be signed before a notary public and carry the notary’s seal, or the entire application is invalid.
Do I send my transcript myself with the packet?
No. Your college or university must forward the official transcript directly to the Board, showing your graduation date and the degree conferred.
Do foreign pharmacy graduates use this same form?
Yes. Foreign graduates use this form but submit FPGECC certification instead of a U.S. transcript and document a 1,440-hour internship.
Do I pay one fee or two?
No. You pay more than one; the nonrefundable application fee is $125, and the criminal history background check carries a separate fee, both by check to the State of New Jersey.
Do I check “Yes” on question 9 if my record was expunged?
Yes. If the question’s wording applies to you, check Yes and attach the judgment, release papers, and an explanation, since honesty protects your application.
Do I need to attach immigration documents if I am a permanent resident?
Yes. You must attach copies of the front and back of your alien registration card or other USCIS documentation that proves your status.
Do I file this form online through MyLicense?
No. First-time applicants generally mail the paper packet to 124 Halsey Street in Newark; MyLicense mainly handles later renewals and uploads.
Do I take the NAPLEX before or after the Board approves my application?
No. You take the NAPLEX and MPJE after the Board approves your application, since approval is what clears you to test through NABP.
Do I list licenses from other professions in the “other license” section?
Yes. The question covers any professional license, certificate, permit, or registration, so list credentials from any field and jurisdiction, even expired ones.
Do I use the reciprocity form instead if I have an out-of-state license?
No. You use reciprocity only if your out-of-state license is active and in good standing and you practiced 1,500 hours in the past two years; otherwise use this form.
Do I sign the certification before checking my documents?
No. Sign and date the final certification last, after every field is answered and every document is attached, because your signature certifies the packet is complete.
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