Request Information

First Name *

Last Name *

Email *

Phone Number

Are you eligible to be a Licensed RN in California?

How would you like to be contacted? Phone Email Either

What time of the day is best to reach you? Morning Afternoon Night

Consent

Comments

The information you provide on this form will be processed in accordance with Samuel Merritt University’s Privacy Policy. Samuel Merritt University will use the details you provided to contact you about your inquiry. Msg and data rates may apply. I consent to receiving information (by email, phone or text/SMS) about the courses and services offered by Samuel Merritt University.