Scholarship Form Celebrate education the legacy of Kit Murphy by applying today! All applicants must be an employee or immediate family member of a CASBA member. Printable form Step 1 of 8 12% Applicant InformationFirst* Last* Address City State Zip Phone Applicant Parent / Guardian InformationFirst Last CASBA Member Company Job Title Years of Service Relationship to Applicant Phone High School InformationHigh School Address City State Zip Graduation Date MM slash DD slash YYYY GPA PSAT Verbal PSAT Math SAT Verbal SAT Math ACT English ACT Math Other Scores Post-Secondary School InformationSchool City State PhonePlease check one: 4-year College / University 2-year Vocational Other Currently Enrolled As: Freshman Sophomore Junior Senior Graduate N/A / High School Other Student does / will: Live on campus Live off campus Commute Student will pay: In-state tuition Out-of-state tuition Major GPA Expected Graduation Date MM slash DD slash YYYY Work ExperienceDescribe your work experience over the past four years.CompanyTitleDates (from/to)Hours/WeekPaid (Y/N) Activities, Awards & HonorsList all activities in which you have participated during the past four years. Scholarship AwardsList the name and amount of any grants or scholarships you have already been awarded.NameAmountGranted / Pending Goals & AspirationsWrite a statement of your plans as they relate to your educational and career objectives and future goals.Certification I have read, understood and hereby agree to the following:Upon submitting this application, I certify that the information provided is complete and accurate to the best of my knowledge. If requested, I agree to provide proof of information for this form. Falsification of information provided may result in termination of any scholarship award consideration.