Application for National Honor Society Membership. River Valley High School 2250 East Laguna Drive Mohave Valley, AZ 86440

Transcription

1 Application for National Honor Society Membership River Valley High School 2250 East Laguna Drive Mohave Valley, AZ Character Scholarship Leadership Service

2 Student s name Grade 1. I am aware that I am eligible for consideration for membership in the National Honor Society based upon my current cumulative grade point average. 2. I am aware that membership in the National Honor Society is based upon a multi-criteria selection procedure. A high academic average, in and of itself, is no guarantee of membership in the National Honor Society. NHS membership is based on scholarship, leadership, character and service. 3. I understand that if I am asked to join the Jean Evins Chapter of National Honor Society, I must abide by the membership bylaws. I understand that I must attend regular meetings and volunteer time outside of school hours. 4. I have had an opportunity to ask questions and to receive clarifications about the selection procedures and the criteria which will be used to determine whether or not I am selected for membership in the National Honor Society. 5. I am aware that I must complete this application packet AND this acknowledgement sheet (signed by my parent(s)/guardian(s)) and return them to an adviser on or before the announced deadline. An application with missing signatures will be considered incomplete. 6. I understand that completion of these forms does not guarantee membership but that I am only being considered for membership in the National Honor Society. Student Signature Date I/We as parent(s)/guardian(s) of the above named student have read the application and understand that if my child is accepted he/she will be held accountable to the chapter bylaws. I/We also realize that a student must meet all criteria for selection: academic average alone does not qualify a student for membership in the National Honor Society. I/We agree to let the above named student participate in the consideration and selection procedures. Parent or Guardian Signature Date Applications must be returned to Ms. Rosenberger no later than Monday, April 3:10 pm. Your application will not be accepted late, even if you are absent on this date. JEAN EVINS CHAPTER OF THE NATIONAL HONOR SOCIETY STUDENT APPLICATION Directions: Please complete all areas of this form. Do not be modest. All information is useful to the faculty council. This must be typed, printed (with all sections completed signature page too) and returned to Ms. Rosenberger by the deadline.

3 Completion of this form is necessary for selection yet does not guarantee selection. Any section that is left blank without subsequent explanation will be considered invalid. National Honor Society is an organization dedicated to four concepts. Our Faculty Council is looking for these qualities in you. Leadership includes students with initiative and resourcefulness; who inspire positive behavior in others who are able to delegate responsibilities. Service includes students who are dependable and well organized; who work with others and are willing to take on difficult or inconspicuous responsibilities. Character includes students who take criticism willingly uphold principles of morality and ethics, and consistently exemplify desirable behavior. Scholarship includes students who are willing to uphold and maintain a loyal school attitude and academic standards. I. Administration Information: Name: First Middle Last Address: Street City State Zip Code Phone: ( ) - Grade Cumulative GPA II. Sections required: A. Co-curricular Activities: List all activities in which you have participated during high school. (Example: clubs, teams, musical groups.) Include a few details about your accomplishments in those activities. ACTIVITY of participation Primary Accomplishment(s) B. Leadership Positions: List leadership positions which you have held or currently hold in school, in the community, or at work in which you have been responsible for directing or motivating others. (Examples: student body/class/club officer, tutor, teaching assistant, committee chairperson, team captain, newspaper editor or staff, work area manager.)

4 Position of participation Name of Organization C. Community Activities: List activities you have participated in outside of school that have contributed to the betterment of the community. (Examples: church groups, 4H, clubs sponsored outside the school, Boy or Girl Scouts, volunteer groups or community art endeavors.) Community Activity of participation Average number of HRS/WK contributed Primary Accomplishments D. Work Experience, Recognition, and Awards: List all (paid or volunteer) job experiences, honors and/or recognitions that you have received which support this application for National Honor Society membership. Position of participation Name of Organization

5 III. Referrals: Please list any disciplinary referrals that you have received on or off record, and why you received it. Reason for Referral that apply Student Name Staff Member Name Staff members: Thank you for filling out this recommendation to River Valley High School s National Honor Society for the above named student. As established by the national charter, in order to become a member, a student must not only excel in scholarship, but also in leadership, character and service. We ask that you rank this student on these four areas. Please check the box that is appropriate. Outstanding Good Fair Poor Unable to judge Scholarship Character Leadership Service What comes to mind when you think of this student?

6 Is there anything else you would like us to know about this student? If you marked poor in the chart above, please explain. Thank you for your time. Please drop this confidential recommendation form in the mailbox of Ms. Rosenberger cut Student Name Staff Member Name Staff members: Thank you for filling out this recommendation to River Valley High School s National Honor Society for the above named student. As established by the national charter, in order to become a member, a student must not only excel in scholarship, but also in leadership, character and service. We ask that you rank this student on these four areas. Please check the box that is appropriate. Outstanding Good Fair Poor Unable to judge Scholarship Character Leadership Service What comes to mind when you think of this student? Is there anything else you would like us to know about this student? If you marked poor in the chart above, please explain. Thank you for your time. Please drop this confidential recommendation form in the mailbox of Ms. Rosenberger. III. Staff Member Recommendation: Detach the two recommendation forms and please ask two staff members to complete them and return it to the teacher mailboxes. (Do not return them to us yourselves.) Please indicate below to whom you gave the forms and dates. Staff member s name Date in which you gave it to him/her

7 IV. Short Response: Please answer the following essay questions (no more than 300 words each). Type them below each question. a. We know you are a successful student; tell us more about who you are as a person what makes you different or unique? b. What lies behind us and what lies before us are small matters compared to what lies within us. Henry David Thoreau Explain how this quote relates to your life, to the choices you make, to goals that you set or difficulties that you have faced.