Daniel Murphy Scholarship Fund - Class of 2027 Application - Due: October 3, 2022

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Student continued
An applicant is a first generation student if his/her parents and/or grandparents did not graduate from a four year college or university..




Other Guardian

Page 3: APPLICANT QUESTIONNAIRE: This section is to be completed by the student/applicant.

High Schools

What is your neighborhood public high school? 

Boarding School

Select all sports in which you participate now:                                                                                                                                                               

Select all sports you wish to play during high school:                                                                                                                                                   

Select all programs in which you participate now:                                                                                                                                                        

Select all programs in which you wish to participate during high school:                                                                                                                  

List any hobbies:              

List any summer academic programs or other supplemental or enrichment work you completed outside of school:

Short Answer (Less than 250 characters)

My proudest moment    
I am concerned about
One book I enjoyed
I am best at  
Others would describe me as
I would like to be better at
One lesson I have learned is
Please select only TWO  of the following three essay questions.  Complete the selected essay questions in fully developed paragraphs.
Essay Question 1: Describe a significant challenge you've had in your life and how you dealt with it. What did you learn? How did this challenge change or influence your way of thinking? (Maximum 500 words)


You must provide information for the three references listed below. If you participate in an extra curricular activity you can include an additional recommendation form but a fourth form is not required.  Your chosen recommenders will receive an email instructing them on how to complete the reference form online. 
7th Grade English/Language Arts Teacher
First Name
Last Name
7th Grade Mathematics Teacher
First Name
Last Name
Guidance Counselor or Principal
This should be either your current guidance counselor or your current principal, whoever knows you better.
First Name
Last Name
Special Interest
This is an optional recommendation form. This should be someone who is familiar with a specific talent or accomplishment of yours in the area of athletics, the arts, student government, club membership etc.

Page 5: PARENT QUESTIONNAIRE. This section is to be completed by the parent/legal guardian of the applicant. Preguntas para la Madre, el Padre, o el guardián legal

What is the language or dialect spoken at home? ¿Qué idioma hablan en su casa?
If selected, you and your child will be interviewed separately. Interviews are conducted in English. Will you need an interpreter?                ¿Las entrevistas son en inglés y usted y su hija/hijo serán separados. ¿Necesitará un traductor durante su entrevista?
What qualities does your child exhibit that make him/her a good scholarship candidate?                                                                                   ¿Qué cualidades posee su hija/hijo que la/lo hace una/un buena/buen candidata/candidato para esta beca?
What has your child done to demonstrate leadership?                                                                                                                                         ¿Explique que ha hecho su hija/hijo para demonstrar liderazgo o características de ser un lider?
Explain any significant factors that have positively or negatively impacted your child.                                                                                  ¿Explique algunos factores importantes que ha hecho un impacto, positivo o negativo, a su hija/hijo?
Would you consider boarding school for your child?                                                                                                                                                       ¿Es posible que usted considere una escuela secundaria de internado para su hija/hijo?
What circumstances make financial aid necessary for you and your family?                                                                                                     ¿Cuáles circunstancias hace la ayuda financiera una necesitad para su familia?
Why do you want your child to be part of the Daniel Murphy Scholarship Fund and attend a private high school?                                     ¿Porque le gustaría que su hija/hijo ser parte del Daniel Murphy Scholarship Fund y asista a una secundaria privada?

Page 6: FINANCIAL INFORMATION.  This section is to be completed by the parent/legal guardian of the applicant.  DMSF requires information for both custodial and non-custodial parents.

Household Information

If applicant’s parents are separated, divorced, or have never been married, please list below                              
Year of divorce or separation:
Is there a joint custody agreement?
Is there a parent living elsewhere with whom the applicant has contact or who provides any financial support?
Total number of adults living in the household:   
Total number of children living in the household:
Parent/Guardian A

Parent/Guardian B

Enter all other people living in the home. Include name, age, and whether the person is a dependent or adult. For adults, include the occupation & employer if applicable. For dependents, indicate the school or preschool name, its annual cost, and who is paying for portions of that cost. 
Parents/Guardian Monthly Income & Expense Information for 2021 (round to the nearest hundred dollars - no decimals)
1. Parent/Guardian A—Total monthly income expected from all sources (before taxes)
2. Parent/Guardian B—Total monthly income expected from all sources (before taxes)
3. Earnings of any adult with whom domestic expenses are shared (before taxes)
4. Monthly Social Security Benefits received for all family members
5. Monthly TANF or general assistance expected
6. Child Support expected (monthly)
7. Non-taxable income expected (monthly)
8. Other taxable income expected (monthly)
9. Sum of items 1-8 (per month)
10. Rent or Mortgage Payment (including property taxes/insurance)
11. Monthly Transportation / Auto
12. Monthly Food, Clothing, Utilities
13. Total medical/dental expenses not reimbursed by insurance companies (monthly)
14. Monthly support payments to former spouse
15.  Monthly Insurance Cost (Life, Auto, etc.)
16. Monthly Elementary & secondary school tuition payments
17. Other unusual or extraordinary expenses
18. Sum of items 10-17
Who else, if anyone, is providing any financial support to applicant or family?
How much (per year)?
Amount of tuition you can afford on a monthly basis for the next school year:
Do you expect any significant change to your income next year?
If so, please explain:
Assets & Debts
Unpaid second mortgage or home equity loan:
Do you own any other real estate?
Other Real Estate
Year purchased:
Purchase price: 
Unpaid principal:
Annual payments on all other real estate:
Do you own or co-own a business or farm?
Total Assets:
Total Debts:
(please list average balance if applicable)
Investments, stocks, bonds, mutual funds:
do not include retirement accounts
Retirement plans, IRA’s, SEP’s or Keoghs:   
List all family cars (year, make, model)

Financial File Uploads:  An application is not complete without submission of financial documents.  All parents, custodial or non-custodial, and legal guardians are required to submit tax documentation (1040s and W-2s for 2021, or any other pertinent financial documents).  Please scan and upload all pertinent financial documents for review.  An application will not be considered if the requested financial documents are missing.

Carefully Read and Sign the Following:
I/We declare that the information reported on this form, to the best of our knowledge and belief, is true, correct and complete. I/We recognize that intentionally providing false information may impact our ability to receive any financial aid/or our child's right to become or remain a DMSF scholar. I/We authorize DMSF to share this application with DMSF's partnership schools. I/We acknowledge that all statements made in this application are made for the purpose of obtaining financial aid; any agent or employee of DMSF or its partner schools may verify or re-verify any information contained in the application from any sources named in this application; DMSF may continuously rely on the information contained in the application; and I/we are obligated to amend and/or supplement the information provided in this application if any of the facts that I/we have represented should change.