Madeleine Dugger Andrews National Junior Honor Society Student Activity Form

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1 Madeleine Dugger Andrews National Junior Honor Society Student Activity Form The National Junior Honor Society (NJHS) recognizes students who excel academically, demonstrate strong leadership, citizenship and character, and commit service to the community. These five categories are based on the five pillars of the National Junior Honor Society: scholarship, leadership, citizenship, service, and character. Take the time to consider all you have done in these areas. Please complete all sections. Print clearly in blue or black ink. Do not be modest, as every bit of information will be used by the Andrews Middle School Faculty Council to assist with the fair consideration of your candidacy during the selection process. Completion and submission of this form does not guarantee selection. Please submit your completed application to the front office no later than the due date indicated on the last page of this packet. Late applications will not be considered. Should you have questions about this form, please contact Ms. Abrimian, your chapter advisor, at Administrative Information: Student Name Side (A or B) Homeroom Teacher Room #

2 Scholarship A scholar displays a sincere desire to succeed academically and shows a love of learning. A scholar also maintains a steady B or above grade average in all academics and has achieved the honor roll every quarter. Character Your character is the combination of qualities that distinguishes you from another person. It is your combined moral and ethical make-up. Your qualifications for this pillar should be explained in the required personal letter. The student of character: Takes criticism willingly and accepts recommendations graciously. Consistently exemplifies desirable qualities of behavior (cheerfulness, friendliness, poise, stability). Upholds principles of morality and ethics. Cooperates by complying with school regulations concerning property, programs, classrooms, halls, etc. Demonstrates the highest standards of honesty and reliability. Regularly shows courtesy, concern, and respect for others. Observes instructions and rules, is punctual, and responsible both inside and outside the classroom. Has powers of concentration, self-discipline, and sustained attention as shown by perseverance and application to studies. Manifests truthfulness in acknowledging obedience to rules, avoiding cheating in written work, and showing unwillingness to profit by the mistakes of others. Creates a climate of kindness and hard work in the school.

3 Citizenship Citizenship is a concept of participation concerning your attitude, fairness, and respect for fellow human beings. Good citizenship encompasses your behavior in and out of school. The student who demonstrates citizenship understands the importance of civic involvement, has a high regard for freedom, justice, and democracy, and demonstrates mature participation and responsibility through involvement with such activities as scouting, community organizations, and school clubs. It also includes your duties, rights, and privileges as a citizen of Andrews Middle School. For example, this may entail your efforts to help make Andrews a better place. Please fill out the following chart attesting to your citizenship while at Andrews Middle School. Add any comments you feel are necessary to explain. (Any suspensions, write-ups, or infractions of behavior and discipline code at school or in the community will lead to disqualification of candidacy.) Grade 6-7th Citizenship Supervising Adult and phone number Comments:

4 Leadership The NJHS tries to develop good leaders. A leader does the right thing without being asked. Your leadership ability is shown by the extra activities you are involved in, whether you hold an office or not. Please list activities in which you have participated (in school or outside of school leadership positions) and note any major accomplishments in each. (You may include sports teams, scouting, clubs, etc.) Only those positions in which you were responsible for directing or motivating others should be included. Please include the signature and phone number of the adult responsible for supervising your leadership in each position. The student who exercises leadership: Is resourceful in proposing new problems, applying principles, and making suggestions Demonstrates initiative in promoting school activities Exercises positive influence on peers in upholding school ideals Contributes ideas that improve the civic life of the school Is able to delegate responsibilities Exemplifies positive attitudes Inspires positive behavior in others Demonstrates academic initiative Successfully holds school offices or positions of responsibility; conducts business effectively and efficiently; demonstrates reliability and dependability Is a leader in the classroom, at work, and in other school or community activities Is thoroughly dependable in any responsibility accepted Is willing to uphold scholarship and maintain a loyal school attitude Grade 5-7th Leadership Position Activity/Organization Supervising Adult and phone number

5 Service List service activities in which you have participated. These can be individual or group service projects done either in or out of school. Generally, service activities are those that are done for or on behalf of others (not including immediate family members) for which no compensation (monetary or otherwise) has been given. Please ask an adult supervisor or someone who can verify your participation in each activity to sign on the appropriate line, and also list the estimated number of hours you invested while performing this service. (You may submit your Volunteer Service Log with the appropriate signatures if you have been keeping one in addition to filling out the chart below.) The student who serves: Volunteers and provides dependable and well organized assistance, is gladly available, and is willing to sacrifice to offer assistance Works well with others and is willing to take on difficult or inconspicuous responsibilities Cheerfully and enthusiastically renders any requested service to the school Is willing to represent the class or school in inter-class and inter-scholastic competition Does committee and staff work without complaint Participates in some activity outside of school, for example, Girl Scouts, Boy Scouts, church groups, or volunteer services for the elderly, poor, or disadvantaged Mentors persons in the community or students at other schools Shows courtesy by assisting visitors, teachers, and students Grade 6-7th Activity Hours of Service Supervising Adult and Phone Number

6 Additional Activities Student Activity Form (cont.) Other Student Activities: List all other activities (not listed in previous sections) in which you have participated. Include clubs, teams, musical groups, etc., and any significant accomplishments in each. Grade 5-7th Activity Accomplishments Work Experience, Recognition, and Awards: Though not a specific criterion for membership, please list below any job experiences, honors, or recognition that you have received that support your candidacy for membership in the National Junior Honor Society. Grade 5-7th Job, Recognition, or Award Group or Activity Hours Spent on Activity (if applicable) Supervising Adult (name and phone number)

7 National Junior Honor Society Teacher Recommendation Form (Print out this page and submit to main office by May 1 st.) This student is eligible for membership in the National Junior Honor Society (NJHS). Students must obtain four signatures from 6 th or 7 th grade teachers. (Only two may be 6 th grade teachers.) *Candidates, please be considerate by requesting recommendations after school only. Selection for membership is based on outstanding scholarship, citizenship, character, leadership, and service. Once selected, members have the responsibility to continue to demonstrate these qualities. If you would recommend the candidate, as you believe he/she exhibits qualities of scholarship, citizenship, character, leadership, and service, please sign in the space below. 1. I recommend this candidate, without reservation, for membership in the NJHS. Teacher Signature Print Name Brief explanation of your recommendation (optional): 2. I recommend this candidate, without reservation, for membership in the NJHS. Teacher Signature Print Name Brief explanation of your recommendation (optional): 3. I recommend this candidate, without reservation, for membership in the NJHS. Teacher Signature Print Name Brief explanation of your recommendation (optional): 4. I recommend this candidate, without reservation, for membership in the NJHS. Teacher Signature Print Name Brief explanation of your recommendation (optional):

8 Candidate Personal Essay Guidelines For your Personal Essay, you are asked to write words explaining why the Faculty Council of the Andrews Middle School National Honor Society should choose you to be a member of the NJHS. Describe why you think you should become a member of NJHS, keeping in mind the five pillars. Explain how you have exemplified each pillar throughout your middle school career thus far (5 th grade may be applied). Follow the individualized paragraph directions below to help you in writing your essay. Below you will find a description of qualities that are reflective of students in the National Junior Honor Society. Explain on a separate piece of paper how you personally believe that you have exhibited each of these four characteristics. Each area should be covered in a complete paragraph with the appropriate heading of the topic being covered. Please be specific and provide details. Don t be bashful when explaining your accomplishments; be proud of all you have done. 1. Why do you want to become a member of the National Junior Honor Society? 2. Scholarship: Speak about your academic success and accomplishments as a middle school student. 3. Participation & Leadership: Include all school clubs, teams, performance groups, and extracurricular activities in which you are involved; also include any activities sponsored by community, church, or other youth groups, and include any work experiences. Finally be sure to include your accomplishments and achievements while participating in each of these activities. Emphasize your leadership experience. Remember that you do not have to be in charge of an activity in order to demonstrate leadership qualities. 4. Citizenship & Character: Citizenship is your commitment to your city, state, and/or nation. Character is who you are when no one is looking. Show that you demonstrate courtesy, concern, and respect toward each and every individual, regardless of differences. A student with exceptional citizenship and character consistently exemplifies the desirable qualities of cheerfulness, helpfulness, friendliness, trustworthiness, and fairness. 5. Service: Service is one of the main goals of the National Junior Honor Society. With this in mind define what service means to you. In detail clarify the service you have already rendered and volunteered your time to in your community. Then explain what service you would like the NJHS to be involved in while you are a member. Be realistic and specific, keeping our school community in mind. Show that you demonstrate a willingness to volunteer, to gladly take on tasks that benefit the school and/or the community, and to assist others enthusiastically whenever called upon to do so. 6. Why do you think you should be nominated as a member of the National Junior Honor Society? - Please type your essay, double-spaced, in 12 point font. - Please keep your essay to approximately 1 to 1 ½ pages. double spaced. - Proofread! Use proper grammar, punctuation, capitalization, and spelling! - Must be your original work. Please type your essay in the space provided below.

9

10 Membership Requirements after Induction All members must complete 20 hours of community service (through school, church, or other organizations) throughout their 8 th grade year. (A service-hour sheet will be attached to acceptance letters once the application process is complete.) Members must attend all meetings unless they make prior arrangements for another school function (band, choir, drill team, etc.). Meetings are generally once a month on Tuesdays or Thursdays after school. Additional meetings may be scheduled to support specific service projects or activities. Missed meetings must be made up by completing an additional half hour of service for each meeting missed. Numerous missed meetings will result in the dismissal of membership. Students will be required to take part in Homework Club on assigned days (once every few months) to assist AMS students who require tutoring or help on homework. All members are expected to continue abiding by the Five Pillars of Society of NJHS throughout their 8 th grade career. Failure to abide by the rules will result in termination of membership.

11 Candidate and Parent Signatures (Print out this page and submit to main office by May 1 st.) Signatures: I understand that completing and submitting this form does not guarantee selection to the Andrews Middle School Chapter of the National Junior Honor Society. I attest that the information presented here is complete and accurate. If selected, I agree to abide by the standards and guidelines of the chapter and to fulfill all of my membership obligations to the best of my ability. Student Signature Date I have read the information provided by my son/daughter on this form and can verify that it is true, accurate, and complete. Parent/Guardian Signature Date Parent/Guardian phone number(s) Parent address We request this information so that we may notify you regarding important details. Please complete this form and submit via Google Docs by Thursday, May 1 st. Late entries will not be considered Andrews Middle School 3000 Mystic Valley Pkwy Medford, Massachusetts Parents of Candidates: (this half due Friday, April 18 th ) Please sign below to acknowledge you are aware of your child s candidacy for the Andrews Middle School National Junior Honor Society as well as your understanding of the criteria needed for your child to be nominated into the chapter. This bottom half of the sheet will be returned to the Andrews Middle School chapter advisor the very next day after the initial candidacy meeting. Candidate Name Parent Signature

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