Please complete this online supplemental application form.
The deadline for submission is October 1, 2015.
It is required to make your application file complete. Please note the
$25.00 Supplemental Application fee must be received in our office also by
the deadline to complete your file. The application close date is
October 1, 2015. No PTCAS or Supplemental applications will be accepted after that
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 PTCAS 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:
Physical Therapy Admissions - AACC-447
3001 Mercer University Dr
Atlanta, GA 30341
If you have any questions about the Supplemental Application, please contact our office at (678) 547-6391.
(First and Last Names)
Preferred First Name
Preferred Phone (home, work, school and/or cell)
Have you applied to Mercer's DPT Program before? Yes
If so, when?
How did you first hear of Mercer's
Who is (was) your academic advisor? (Optional)
City, State and Zip Code
Please list other PT programs which you are considering:
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/arrests,
i.e., felonies and misdemeanors, infractions, traffic offenses, and
everything else except for parking violations,
regardless of the final disposition.)?
If the answer is YES, give a full explanation here:
As part of your PTCAS application, you are asked to provide a narrative
regarding your personal characteristics and motivating factors that have
led you to pursuing the physical therapy profession.
At this time, please respond to the question below. Please do not reuse your PTCAS statement.
(This field cannot be left blank.)
Identify and discuss three responsibilities for the physical therapist practicing in a state with direct access privileges.
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
If you were enrolled in a professional physical
therapy education program, please provide a detailed explanation of why you
are no longer enrolled in that program and include the name of the program
and dates attended. Please note this only applies to applicants who have
previously attended a professional physical therapy education program.
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 478-301-2786 or contact
email@example.com, or in
cases of Title IX concerns, these concerns may be referred to the Office
of Civil Rights.