Supplemental Application

Please complete this online supplemental application form. The deadline for submission has been extended to March 1, 2012; all applicants are encouraged to submit the Supplemental Application and fee before the deadline to ensure it is received prior to the deadline. It is required to make your application file complete. Please note the $25.00 Supplemental Application fee must be received in our office by March 1, 2012.

Fees must be submitted by check or money order either via postal mail or dropped off at our office.

Please make sure you include your name and PharmCAS ID on your check/money order.  If you are sending materials by postal mail, please use the following address in its entirety so that it will reach our office in a timely manner:

Pharmacy Admissions
Mercer University COPHS
3001 Mercer University Dr, PAC-121
Atlanta, GA 30341

If you have any questions about the Supplemental Application, please contact our office at (678) 547-6232. 

Personal Data 

PharmCAS ID                      

Gender:    Male Female

Name

Name you prefer to be called (nickname)

Phone (home, work, school and/or cell)

E-Mail address          

Religious Preference

Have you applied to Mercer's Pharm.D. Program (or any other Mercer program) before? Yes No

If so, when?

If you are reapplying to Mercer's Pharm.D. Program, please describe how you have improved your application.

How did you first hear of Mercer's Doctor of Pharmacy (Pharm.D.) Program?

Who is (was) your pre-pharmacy or academic advisor?

Name

Title/Department

College/University

City, State and Zip Code

Please list other pharmacy schools which you are considering for attendance:

Do you have relatives who are Mercer University graduates? If yes, please list them (include name, relationship, degree and class year).

 

Have you ever been convicted of any violation of law (include all criminal offenses,
i.e., felonies and misdemeanors, infractions, traffic offenses, and everything else except for parking violations,
regardless of the final disposition.)?

Yes            No
If the answer is YES, give a full explanation here:

Narrative

As part of your PharmCAS application, you are asked to provide a narrative regarding your personal characteristics and motivating factors that have led you to pursue pharmacy as a career and the Doctor of Pharmacy degree. At this time, please respond to the following questions:

Please do not reuse your PharmCAS statement. (Please limit your narrative to 500 words. This field cannot be left blank.)

Optional: Please provide any additional comments or information you would like the Admissions Committee to consider during the review of your application (e.g., causes of any academic difficulty or additional qualifications not already noted). (Please limit this information to 250 words.)

I certify that the information presented in this supplemental application is my own work, factually correct and honestly provided.

Please acknowledge the above statement by typing your name in this box:

 

Mercer University is committed to providing equal educational programs or activities, and equal employment opportunities to all qualified students, employees, and applicants without discrimination on the basis of race, color, national or ethnic origin, disability, veteran status, sex, sexual orientation, age, or religion, as a matter of University policy and as required by applicable state and federal laws, including Title IX.  Inquiries concerning this policy may be directed to the Equal Opportunity/Affirmative Action Officer/Title IX Coordinator, Human Resources Office, 1400 Coleman Avenue, Macon, Georgia 31207, phone 478-301-2788 or contact baca_dh@mercer.edu, or in cases of Title IX concerns, these concerns may be referred to the Office of Civil Rights.