Designated Representative Training Affidavit

If you are applying for a California Designated Representative license, you’ll need to include proof of required training (the training affidavit) in your license application. Here’s some info, and tips on how to get one.

California Designated Representative Training Affidavit Forms

The training affidavit form is one of several forms embedded inside the entire Designated Representative license application form, available from the California State Board of Pharmacy. This means each training affidavit form is unique to its “parent” license application (for example, wholesaler, 3PL, or reverse distributor).

Here is what the California Board of Pharmacy says about the training affidavit, “Submit this form documenting that you have completed a training program pursuant to Business and Professions Code section 4053. An applicant may not sign as the person with direct knowledge of the applicant’s training.”

How To Earn A Training Affidavit

Since the license applicant can’t sign the training affidavit, the applicant will need to take required training from a Board-approved training provider. It is a “person with direct knowledge of the applicant’s training” who signs the training affidavit on behalf of the training program provider.

There is only one training provider, approved by the Board to offer a training program, and sign training affidavits, for three (3) distinct Designated Representative license types (wholesaler; 3PL; reverse distributor):

If you are applying for a California Designated Representative license, you’ll need to include a training affidavit.
If you are applying for a California Designated Representative license, you’ll need to include a training affidavit.
If you are applying for a California Designated Representative license, you’ll need to include proof of required training (the training affidavit) in your license application.

Keywords & Phrases

Form 17A-E3; Form 17A-E5; Form 17A-E7; California Board of Pharmacy; California State Board of Pharmacy; designated representative; approved; accepted; recognized; certified; training; affidavit; certificate; certification; program; course; class; webinar; seminar; workshop; event; license; application; form; online; web; eLearning; provider; vendor; seller; taught by; presented by; buy; purchase; enroll; register; tips; how to;

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