Thank you for your interest in our Congrats Committee! Please complete the short questionnaire below to participate.

More questions about the program? Please contact Jordana Berry, Director of Admissions: berry_js@mercer.edu; 678-547-6182.

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* 1. Name

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* 2. Year of Graduation

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* 3. Home Address

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* 4. Preferred Email Address

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* 5. Preferred Phone #

Sometimes you may be paired with an accepted student in your area or one with a similar background/interests and other times, the pairing will be random. Please share with us any information that you feel may be helpful in pairing you with an accepted student.

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* 6. What is your hometown/state?

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* 7. Where did you complete your pharmacy prerequisites?

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* 8. Please tell us a little bit about your career. By sharing your employer, title and practice setting, we can work to pair you with a student who has similar interests.

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* 9. Please check the below statements that apply to you:

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* 10. Is there anything else you would like to share that would be helpful in pairing you with a student?

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