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*AddressCityStateZipPhone Applicant Parent / Guardian InformationFirstLastCASBA Member CompanyJob TitleYears of ServiceRelationship to ApplicantPhone High School InformationHigh SchoolAddressCityStateZipGraduation Date Date Format: MM slash DD slash YYYY GPAPSAT VerbalPSAT MathSAT VerbalSAT MathACT EnglishACT MathOther Scores Post-Secondary School InformationSchoolCityStatePhonePlease check one:4-year College / University2-yearVocationalOtherCurrently Enrolled As:FreshmanSophomoreJuniorSeniorGraduateN/A / High SchoolOtherStudent does / will:Live on campusLive off campusCommuteStudent will pay:In-state tuitionOut-of-state tuitionMajorGPAExpected Graduation Date Date Format: 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.