Go to Main Content

Kentucky State University (PROD1208)

 

HELP | EXIT

Thorobred Information Form

 

Transparent Image
Information Please enter the requested information. Please note that an asterisk denotes required information.

Required - indicates a required field.
Information Please select which entry term you will enroll.

Prospect Entry Term
Term of Entry:Required

Information Please enter in all the necessary information.

Prospect Name
Prefix:
First Name: Required
Middle Name:
Last Name: Required
Suffix:
Nickname:

Information Please provide us with an accurate address.

Primary Address
Valid From: Month Day Year (YYYY)
Until: Month Day Year (YYYY)
Address Line 1:Required
Address Line 2:
Address Line 3:
City:Required
State or Province:
ZIP or Postal Code:
County:
Nation:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

Information Please enter in all the necessary information.

Additional Telephone Numbers
Telephone Type:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:
Telephone Type:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:
Telephone Type:
Phone Number: - (xxxxxx)-(xxxxxxxxxxxx) (xxxxxxxxxx extension)
International Access Code:

Information Please provide us with an accurate email address for future communications.

E-Mail Address
E-mail Address:Required
Verify E-mail Address:Required

Information Please select your high school from the lookup button. If it is not listed, please fill out the necessary information.

Prospect High School
Home Schooled (check for yes):
OR
High School Code:
High School Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Graduation Date: Month Day Year (YYYY)
Class Rank and Size: / (must be numeric)
GPA: (example: 9.99, or A+)

Information Please select your Prior College/Colleges attended from the lookup button. If it is not listed, please fill out the necessary information.

Prospect Prior College
College Code:
Prior College Name:
Address Line 1:
Address Line 2:
Address Line 3:
City:
State or Province:
ZIP or Postal Code:
Nation:
Attended From:
Attended To:
Graduation Date: Month Day Year (YYYY)
GPA: (example: 9.99)
Degree:

Information Please enter your anticipated major.

Prospect Major
Major:

Information Please select all the necessary materials you would like to receive. To select multiple materials use Ctrl+Click for PC and Command+Click for Mac.

Requested Material
Request Materials:

Information Please supply your ACT Composite Score or your SAT Critical Reading + Math Score only. *NOTE: Please do not submit your combined score of all three sub-sections.

Prospect Test Scores
Test Type: Test Score: Test Date:
Month Year (YYYY)  
Month Year (YYYY)  
Month Year (YYYY)  
Month Year (YYYY)  

Information Please select your gender.

Prospect Gender
Gender: Male Female Not Specified

Information Please provide us with your accurate Date of Birth.

Prospect Birthdate
Date of Birth:Required Month Day Year (YYYY)

Information Please select your ethnicity.

Prospect Ethnicity/Race
Ethnicity:

Note What is your ethnicity?

Hispanic or Latino
Not Hispanic or Latino

Note Select one or more races to indicate what you consider yourself to be.

American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Declined to Identify Unknown
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Unknown

Information Please select your interests from the options provided. To select multiple interests use Ctrl+Click for PC and Command+Click for Mac.

Prospect Interests
Interests:

Information Please select how you learned about Kentucky State University.

How Prospect Learned About Us
How I Learned About Kentucky State University (PROD1208):

Transparent Image
Skip to top of page
Release: 8.5.4