Application form for Internship Program 2014 July to December 2014


Contact Number: +91 9900407416 Email: Website:

Application form for Internship Program 2014 July to December 2014



Name : DOB/Age :                                         Gender:




Current Program of study:               B.Pharm/M.pharm/PharmD/PharmD (PB)


Pharmacist Registration Number / Yet to register:



Address :




Mobile  Number:                                                           Email id:





Chatting mode :Whatsapp / Gmail/  Facebook /Skype/Viber



Where you wish to do your Internship: Place /Pin No:                                                       State :



Membership:                                                                    ACPIKSPOR



Experience community pharmacy/Services in years:




Preferred mode for stipend payment:  Demand Draft/ Multi city Check/ Bank Transfer





Contact Number: +91 9900407416 Email: Website:


Terms and conditions for Internship


  • The Award of internship is at the discretion of the company


  • The intern should have basic computer skills


  • The Internship comprises of six month duration and there are no fees for internship


  • There is no binding or MOU with any person or college for the internship


  • The timing of service is left to the discretion of the intern and shall provide service minimum of 20 patients to earn a stipend of Rs 2000/-per month


  • The intern should report the format on or before 20th calendar date of every month and should submit the amount generated in the preceding month  by him by 5th calendar date  of the month by DD/bank transfer


  • The services provided comprises of Community settings and Home based ;


  • The intern should submit a soft copy of report of Internship at end of 5th Month to get certificate of internship


  • The internship report should comprise of details of experience / services provided/ problems faced and how they overcome in community pharmacy services


  • The intern shall get 50% of the revenue he makes for the company


  • The registered pharmacist should give the proof of registration, and students should provide a copy of their student ID


  • In case the intern needs equipments of practice, he needs to deposit Rs 2500/- which shall be refunded after receiving the equipments in working conditions


  • The equipment kit comprises of BP apparatus, stethoscope, weighing scale


  • On successful completion of internship the candidate shall be awarded internship certificate by the company