Austin Scholars Interest Form

Filling out this form lets us know you are interested in learning more about the Austin Scholars Program at Merrimack.

* denotes required field

Student Contact Information

Are you a currently enrolled Merrimack Student*?

First Name (given name, not nickname)*

Last Name*

Email Address*

Birthdate*

Mobile Phone*

Please enter your Merrimack ID (optional)

I am interested in living in a dynamic community at Merrimack, integrating community service into my college experience, and taking classes with peers that will help me develop as a leader.

Yes, I'm interested

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Austin Scholars Interest Form