Visit Request

Instructions Please fill out the form below to request a visit from an Ole Miss Pharmacy representative or pharmacist.

First Name *

Last Name *

Phone *

Email *

School Name *

Graduation Year

Visit Setting *

Please choose the option(s) that best fit your visit.Prospective Student VisitTeacher/ HOSA advisor/Admin requesting a pharmacy tour - Oxford CampusTeacher/ HOSA advisor/Admin requesting a pharmacy tour - Jackson CampusTeacher and would like Ole Miss Pharmacy to speak in my classroom.Other

Comments

*Please include official campus tour date if scheduled.

Verification