Kentucky State University

First Name*

Middle Name*

Last Name*

Student ID#*

Classification*

Freshman

Sophomore

Junior

Senior

Graduate student

Gender*

Male

Female

Phone number*

Kentucky State University Email Address*

Learning

How would you prefer to attend classes at Kentucky State this fall?*

Hybrid (in-class/synchronous) instruction: Students will attend class, both face-to-face with reduced classroom size and attend class synchronously via the University learning platform – Blackboard – on alternating days.

Online/asynchronous instruction: students will receive instruction via the University learning platform – Blackboard – by engaging with material provided and/or recorded by faculty.

Students who chose the hybrid option will have the flexibility to revert to online instruction if they become uncomfortable with face-to-face instruction. Kentucky State wants its students to feel comfortable and choose the option that is best for each student’s health, safety and well-being.

Living

What housing option do you plan to choose for the fall semester?*

Live in the residence halls with no roommate

Live in the residence halls with a roommate

Live in hotel with a roommate

Live off-campus

Live at home

Preferred Roommate's First Name*

Preferred Roommate's Middle Name*

Preferred Roommate's Last Name*

Preferred Roommate's Student ID#*

Preferred Roommate's Gender*

Male

Female

Preferred Roommate's Phone Number*

Preferred Roommate's Kentucky State University Email Address*

Residence Hall First Preference*

Residence Hall Second Preference*

Questions/comments

BREDS Choice

Learning

Living