Speech Language Pathology Pre-Requisite Application

Student Personal Information

First Name

Middle Name

Last Name

Preferred First Name

Birthdate

Sex at Birth

Gender Identity

If you would like the opportunity, we invite you to share more about your gender identity:

Are you of Hispanic/Latino ethnicity or descent?

Race

Primary Citizenship

Are you a U.S. Permanent Resident?

Yes

Social Security Number (please omit dashes):

Social Security Numbers are collected for financial aid awarding purposes. If you do not have a Social Security Number and want to talk about your financial aid options, please contact admissions@gmercyu.edu. Additionally, please be sure that the name you enter in the First Name and Last Name fields match the name on your current Social Security Card.

Student Contact Information

Email Address

Mobile Phone

Can we text you with information about being a student at GMercyU?

Yes

Mailing Address

Country

Street

City

Region

Postal Code

Student Academic Information

Program of Interest

Enrollment Term

College/University Attended
(If you cannot locate your school in the dropdown, please type the name, city and state of the school.)

College/University Level of Study

College/University Program of Study

College/University Degree

College/University Graduation Date

Would you like to add an additional college attended?

Yes

College/University Attended
(If you cannot locate your school in the dropdown, please type the name, city and state of the school.)

College/University Level of Study

College/University Program of Study

College/University Degree

College/University Graduation Date

Additional Information

Housing Plans While Attending GMercyU

Are you a GMercyU alumni?

Yes

Are you the first in your family to attend college?

Yes

Disclaimer and Review

By submitting this application, you certify that the information submitted is true, accurate, and complete. Failure to make full and truthful disclosure of all information requested will result in disqualification or revocation of admission. As part of your application, you must provide official transcripts of all colleges/universities attended, and other required materials as outlined on the Admissions page of the GMercyU website. We look forward to reviewing your application!