KY Coal County College Completion Scholarship Program - Interest Form

To find out more about how you may qualify to use the KCCCCS at MSU Prestonsburg, please complete this form.

Are you currently enrolled at MSU and taking at least one class at MSU Prestonsburg? Yes  No 

Name:  

Address:  

City:  

State:  

Zip Code:  

Phone:  

E-mail:  

What high school did you attend?  
           or In what county did you receive your GED?  

What college did you attend?  

How many hours have you completed?