Mercer University

* = Required Field

Basic Information

Please use proper case when typing your legal name and address.
- * First Name
- Middle Initial
- * Last Name
- Suffix
- * Date of Birth
  
  [mm/dd/yyyy]
Enrollment Information
- * Location of Interest
- * Program of Interest:
- * Anticipated Term of Entry
- * Citizenship
- Highest Degree Attained:
- College at Mercer
- * Lead Status
Contact Information
- * Address Line 1
- Address Line 2
- * City
- State
- * Zip/Postal Code
- * Country
- * Email
- * Phone Number
What is your preferred method of contact?
What is your preferred video chat tool?
- *
If you are outside the US, please enter your International Phone Number
- * International Phone Number
Military Status
Career
- * Current Industry:
- * Years of Work Experience:
Additional Information
- How did you hear about Mercer before exploring the website?
Questions/Comments:
- * I want to receive text communications regarding enrollment:
  
  Mercer does not share or sell information; messaging charges may apply. Opt in or out at any time.
- * Cell Phone Number