Supplemental Application

Please complete this online supplemental application form. Please note the $25.00 Supplemental Application fee must be received in our office within five days of submission of the Supplemental Application. 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:

Student Affairs and Admissions Office
Mercer University College of Pharmacy and Health Sciences
3001 Mercer University Dr, STE 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 the Mercer University College of Pharmacy and Health Sciences before? Yes No

If so, when?

How did you first hear of Mercer's College of Pharmacy and Health Sciences?

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 a misdemeanor (excluding minor traffic violations)?
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 desire to pursue pharmacy as a career and the Doctor of Pharmacy degree.

At this time, please describe how participation in Mercer's Doctor of Pharmacy degree program will foster your development as a healthcare professional. 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 and employment opportunity to all qualified students, employees, and applicants, without discrimination on the basis of race, color, national or ethnic origin, sex, age or disability, as a matter of University policy and as required by applicable State and Federal laws, such as Title IX and Section 504. Inquiries concerning this policy may be directed to the Equal Opportunity/Affirmative Action Officer, Diane Baca, Personnel Office, 1885 Edgewood Avenue, Macon, GA 31207, (478) 301-2786.