APPLICATIONS FOR MEMBERSHIP IN SCIENCE HONOR SOCIETY



APPLICATION FOR MEMBERSHIP

NEW YORK STATE SCIENCE HONOR SOCIETY

LANCASTER CHAPTER

Name_______________ _____________ Grade _____

(Last, First)

Student number ______________ Phone Number _____________

(That you can be reached at)

Home Address______________________________________________

_______________________________________________

Science Honor Society Membership Requirements:

❖ Membership is based on science scholarship, service and character.

❖ Applicants must have demonstrated exemplary character and citizenship.

❖ Applicants must have completed a minimum of 3 semesters (1.5 years) of high school science. Semesters are 20-week periods. Taking Living Environment in 8th grade counts as 2 semesters, or 1 year, of high school science.

❖ Applicants must have a minimum cumulative science average of at least 85% and a minimum cumulative Mathematics Average of 75%.

❖ Applicants are required to have a minimum cumulative overall scholastic average of 80%

Requirements for Science Honor Society once Accepted:

➢ 24 credits for the school year (6 per quarter or 12 per semester)

➢ Participate in Service Projects done by the group

➢ Help out wherever help is needed

➢ Be enrolled in a Science Class for EVERY YEAR of High School

Directions:

Please complete all sections. Do not be modest. Every bit of information may be used to assist with the selection process. Completion of this form does not guarantee selection. Please print neatly. All information will be kept confidential and will be verified. Note, you do not need to fill up all the space to have a good application. We give more space than is usually needed!

Part One:

Record of all High School Science Courses:

| | | |

|Course Title |Final (or mid-year) Overall Average |Teacher Name |

| | | |

|Living Environment | | |

|Level: | | |

| | | |

|Earth Science | | |

|Level: | | |

| | | |

|Chemistry | | |

|Level: | | |

| | | |

|Any Other Electives or Science Courses | | |

|Taken: | | |

Part Two:

Extracurricular and Community Service Activities

List all activities in which you have participated or plan to participate in during high school. Include elected leadership appointments or offices you have held.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Part Three:

Possible Careers!

List below a career(s) that interests you and explain how, not only will your Science classes taken will affect you achieving that career, but also how membership in the Science Honor Society will also affect that achievement.

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(Use this blank area if needed for answers. This is not necessary.)

Part Four:

Personal Statement(s)

❖ Write a short paragraph indicating your expectations of, as well as your possible contributions to, the Science Honor Society.

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

❖ List any ideas that you have for any service projects or Science-related Activities that the Science Honor Society could get involved in and also that you would enjoy participating in.

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Teacher recommendation form for application to the Science Honor Society

Directions to student: Two copies of the recommendation form are attached. Please ask two faculty members, either two science teachers or one science and one math teacher, to provide references for you. Fill in your name, the teacher’s name and the subject on each form. Give the forms to the teachers by Tuesday, March 25th, and ask them to complete and return the forms to Mrs. Miller by Friday, March 28th.

Lancaster Chapter of the NYS Science Honor Society

Teacher recommendation form for

(name of student)

Teacher Name:

Subject (circle): science or math**

Dear faculty member,

Thank you for agreeing to provide a reference for the above-named student. The student should ask you by March 25th. Please do not accept this form after that date. As part of the criteria for acceptance in the Science Honor Society, students must exhibit science scholarship, service and personal character. Your input is a valuable part of the selection process. Thank you for your time and cooperation.

Please complete the information below and return this form to Sandra Miller by Friday, March 28th 2014. Your prompt return of this form is greatly appreciated. Your responses are confidential.

Please rate the candidate on each of the following items. One is the lowest rating, five is the highest. Please circle the appropriate response.

N/A 1 2 3 4 5 Student displays initiative and

reliability

N/A 1 2 3 4 5 Student shows evidence of

competency in laboratory skills and/or research. (N/A FOR MATH)

N/A 1 2 3 4 5 Student works well and gets along with teacher, classmates or community

N/A 1 2 3 4 5 Student shows excellent problem solving skills and is often "ahead of the class"

N/A 1 2 3 4 5 Student shows leadership qualities

N/A 1 2 3 4 5 Student is conscientious of his/her grades.

Teacher Signature___________________________ Date ___________

Lancaster Chapter of the NYS Science Honor Society

Teacher recommendation form for

(name of student)

Teacher Name:

Subject (circle): science or math**

Dear faculty member,

Thank you for agreeing to provide a reference for the above-named student. The student should ask you by March 25th. Please do not accept this form after that date. As part of the criteria for acceptance in the Science Honor Society, students must exhibit science scholarship, service and personal character. Your input is a valuable part of the selection process. Thank you for your time and cooperation.

Please complete the information below and return this form to Sandra Miller by Friday, March 28th 2014. Your prompt return of this form is greatly appreciated. Your responses are confidential.

Please rate the candidate on each of the following items. One is the lowest rating, five is the highest. Please circle the appropriate response.

N/A 1 2 3 4 5 Student displays initiative and

reliability

N/A 1 2 3 4 5 Student shows evidence of

competency in laboratory skills and/or research. (N/A FOR MATH)

N/A 1 2 3 4 5 Student works well and gets along with teacher, classmates or community

N/A 1 2 3 4 5 Student shows excellent problem solving skills and is often "ahead of the class"

N/A 1 2 3 4 5 Student shows leadership qualities

N/A 1 2 3 4 5 Student is conscientious of his/her grades.

Teacher Signature___________________________ Date ___________

-----------------------

❖ Applicants must submit:

o This completed application

o Copy of high school transcript and/or report cards to verify grades from the counseling center.

❖ Applicants must ask two faculty members to complete reference forms. The request must be made by Tuesday, March 25th, 2014. Teachers will submit these forms directly to Mrs. Miller in Room 107.

**Note that the Teacher Recommendation Form has a choice for a MATH TEACHER to recommend you. THAT IS ONLY FOR STUDENTS GOING TO BE SOPHOMORES IN THE 2014-2015 SCHOOL YEAR. **

ALL APPLICANTS THAT WILL BE JUNIORS OR SENIORS IN THE 2014-2015 SCHOOL YEAR MUST HAVE 2 SCIENCE TEACHERS RECOMMEND THEM!

YOUR APPLICATION WILL NOT BE ACCEPTED IF THESE REQUIREMENTS ARE NOT MET!!!

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