Delta Epsilon Mu - Interest Form

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Thank you for expressing interest in recruiting for Delta Epsilon Mu!

Please fill out this form with the relevant information, and you will be contacted with recruitment updates and information. Only your name and email address are required to complete this form.

Thank you!

Name (First, Last) *

Preferred Pronouns:

Hometown, State (ex: Orlando, FL) *

Birthdate (mm/dd/yyyy) *

YYYY

Email *

Major/Minor *

Track (Pre-Med, Pre-PA, etc.) *

Graduation Year *

Class Standing *

Freshman

Sophomore

Junior

Senior

Any additional questions, comments or concerns

Submit

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