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 INTERNSHIP TRAINING AFFIDAVIT Michigan 2019-2023

INTERNSHIP TRAINING AFFIDAVIT Michigan 2019-2023

Use a affidavit for internship 2019 template to make your document workflow more streamlined.

Date SECTION II SITE INFORMATION Site Name PRECEPTOR INFORMATION Preceptor Name PRECEPTORSHIP INFORMATION Please separate concurrent a maximum of 16 hours weekly can be gained while in a school from Non-Concurrent Training a maximum of 40 hours weekly can be gained while not in school school breaks vacation etc.. Type or print your name exactly as it appears on your application. Print this form and then for completion of Section II send this form to the Pharmacist Preceptor who supervised your...
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