In order for the application to be processed the student must provide the following information. You may attach .txt, .doc, .docx or .pdf files to this form, or to an email to kba@kba.org

• Copy of High School Transcript
• Copy of ACT and/ or SAT
• Letter of Recommendation by Faculty Member, Employer or Community Leader
• Letter from Parents employer stating employment for more than 1 year

* – required field

First Name:*
Middle Name:
Last Name:*
Email:*
Phone:
Street Address:
City:
State:
Zip:
Birthdate:*
Parent Information: One of the student’s parents must be a full time employee of a KBA member station on the date of the application deadline and has been employed at the KBA member stations for a period of a year prior to the application deadline.
Parent First Name:*
Parent Last Name:*
KBA Member Station:*
City of License:*
Employment Status:*	Full Time Part Time
How Long Employed:*
Higher Education Institution to be Attended:*
Phone:
Address:*
Address 2:
City:*
State:*
Zip:*
Extracurricular Activities: Students should list all Extracurricular activities (clubs, athletics, church, community service, part-time employment, etc.)
Awards and Honors: Student may provide a list of awards and honors:
Submission Information: The deadline for applications will be Sunday, April 15, 2018. Submission is online. For questions contact the KBA office at 1-888-843-5221 or kba@kba.org
NOTE: You will have the opportunity to verify/edit your entries, and to attach files on the next page.