Application for National Honor Society



431800-23622000Portfolio for National Honor SocietyBriar Woods High SchoolCongratulations! Based on your academic grade point average you are invited to apply for membership in the Briar Woods Chapter of the National Honor Society. A faculty selection committee will soon be reviewing all eleventh andtwelfth grade students who are academically eligible for membership and have submitted portfolios. Membership in the National Honor Society is based upon excellence in four areas: scholarship,leadership, service and character. Each category is judged independently.To be eligible for membership, students must have at least a junior standing, and a weighted cumulative GPA of at least a 3.5. In addition to the academic requirement, there are standards in leadership, service, and character, which are required. Leadership requirements include a demonstration of leadership in school as well as outside of school. Service requirements include involvement in service projects since the start of the high school career. Character requirements include integrity, positive behavior, ethics, cooperation, and reliability in and out of school and classroom maturity.After students become members of the National Honor Society, they are reviewed periodically by the advisers and must maintain the high standards of the Society. Active members in the National Honor Society are required to maintain a cumulative 3.5 GPA or better and live up to the character, leadership, and service ideals of the National Honor Society.Students who are invited to apply to the National Honor Society membership are under no obligation to complete the candidate portfolio. Although you are to be commended for maintaining a high scholastic average, please understand that membership is not guaranteed to anyone. The faculty committee makes the final decision for membership. The NHS Advisers are nonvoting members. If you have any questions regarding the Society, the selection procedures or membership, please contact Mr. Mosser or Mr. Sarmento at any time.PLEASE NOTE:Complete ALL sections of the information form. Please type or print with black ink. Do not be modest. The application is the major component of the selection process. Be clear and detailed in your responses.Please prioritize your activities, listing those to which you had the greatest commitment first. Avoid repeating your involvement in organizations/activities in more than one section of the application form.This information form requests the name of an adult sponsor who can verify your involvement in the activities listed. You MUST include the adult sponsor’s name and contact information (e-mail or phone number) and signature. Hours documented on letterhead will be accepted in lieu of pleted applications are due to Mr. Mosser in Room 505 by 4 p.m. on Monday, October 12.Details of the induction ceremony will be discussed after the Selection Committee reaches it decision.Before further consideration, it is necessary for you and your parent or guardian to sign this form (a waiver to any right to access information, evaluations, recommendations, judgments, or whatsoever in the selection process). Further consideration will not be made until this waiver is signed and returned.Student Signature/Date Parent Signature/Date45275548895PART 100PART 1ADMINISTRATIVE INFORMATIONFull NameGrade_ Home Address E-mailPhone Number 452755-60960PART 200PART 2EXTRA-CURRICULAR ACTIVITIESSchool Activities -- List all activities in which you have participated during high school. Include clubs, teams, musical groups, etc., and major accomplishments in each. Include activities you know you will participate in during this school year. For example, if you know you will participate in track, but the season hasn't begun, please include it. List the name of the adult supervisor who can verify your participation in each activity. Verifying signatures and phone numbers are required.School Activities9101112AccomplishmentsSponsor Name and Phone No.Sponsor’s Signature45275555245PART 300PART 3LEADERSHIP POSITIONSLeadership will be divided into two areas, elected positions, and student leadership. List all elected or appointed positions held in which you have been an active member in high school. Include clubs, musical groups, committees etc., and major accomplishments in each. Major accomplishments include, but are not limited to, club officer, president, vice president, secretary, treasurer, and awards. Please list athletics on the table found on the following page only. Verifying signatures and phone numbers are required.Section A: Elected & Appointed Positions- List all elected or appointed positions held in school. Only the positions in which you were directly responsible for directing or motivating others should be included. For example, elected to student council, club officer, committee chairperson, newspaper editor, work manager, church youth group officer, 4‐H officer, etc.Leadership Position91011Accomplishments/Leadership PositionsSponsor Name and Phone No.Sponsor’s Signature Please sign only if this individual is an active memberAthletics example: Sports team captain or co‐captain, etc. VL=Varsity LetterAthletics: Completed Season9101112AccomplishmentsCoach Name and Phone No.Coach’s SignatureSection B: Student Leader & Leadership Examples: Many students are leaders in various ways without ever being elected to a leadership position. In this section we want you to describe how you are a leader in your classroom, school, and /or community. Student leaders are resourceful, good problem solvers, idea contributors, dependable, and have a positive attitude about life. Below list a leadership quality that you possess and then give an example of a time when you demonstrated this leadership quality. Use as many of the spaces below that you desire, you do not have to use each space, but the more information you can provide the better.Leadership QualityExample that Demonstrates this QualityExamples: LeaderDependableI often lead classroom discussion in my English class.I always arrive to my job at Dairy Queen on time, and pick up shifts for others.452755-52070PART 400PART 4SERVICE ACTIVITIESList all the community service activities you have participated in that have benefited the school and/or the community. Generally speaking, service activities are those which are done for or on behalf of others (not including immediate family members) for which NO compensation (monetary or other) have been given. For example, church groups, Boys or Girl Scouts, Habitat for Humanity, Special Olympics. Additionally, if the service activity was a requirement of your membership in an extra-curricular activity, you should NOT include it. (For example, the cross country team, in the past, has cleaned up the stadium after home football games. This was a requirement of its members, therefore would not count toward service hours.)If you participated in any service activity within the school, list and describe that as well, along with the number of hours you performed the service. List the name of the adult supervisor who can verify your participation in each activity. Please try to have the signature be from an adult other than a parent, unless your parent was directly responsible for that activity. Verifying signatures and phone numbers are munity Activity9101112Explanation of ActivitySponsor Name and Phone No.Start & End DateSponsor’s SignatureTotal Hours CompletedAre You Still Doing This?If the above section is left blank, please explain why.45275548895PART 500PART 5WORK EXPERIENCEList below any job/work experiences you have had during high school that support your bid to be selected for membership in National Honor Society. Work experience may be paid or volunteer. Work experience may include some of the following types of activities: babysitting, farm work, lawn work, employment at alocal place of business, etc. Name of Sponsor and phone numbers are required for work experience. Signatures are not required.Job Experience9101112Duties at WorkSponsor Name and Phone No.Start and End DateHours CompletedAre You Still Doing This?405130-92075PART 600PART 6HONORS AND RECOGNITIONSPlease list any awards or recognitions, not already mentioned on this form, which you have received during high school. Examples: Student‐of‐the‐Month, Sportsmanship Award, local art award, etc.Recognition- Formal acknowledgement of an achievement, i.e. special notice or attention.Recognitions9101112Group or ActivityAwards An item that is given to you as an acknowledgement of an achievement, i.e. trophy, certificate (usually a physical item.) Boy Scouts‐Life, Eagle, etc., Girl Scouts‐ Bronze, Silver, Gold Awards.Award9101112Group or Activity376555-50800PART 700PART 7ESSAYPerhaps the most difficult area to evaluate for selection of members is that of character. To assist the faculty advisory committee in their decision, we are asking you to write a brief essay describing how you display character and how you plan to consciously improve in this area by the time you graduate from Briar Woods High School. Please attach a one‐page, double‐spaced, computer generated essay expounding upon this topic. Spelling, grammar and neatness, along with quality of response will be part of the evaluation process. Do not forget to use a spell checker and have someone proofread your paper for mistakes, etc. Responses should be a minimum of 250 words with a maximum of 500 words.demonstrated. Please comment on:The applicant’s commitment to serviceThe nature of the activitiesHow this person demonstrated leadership in events or organizationsAdditional comments about the CHARACTER (honesty, reliability, etc.)of the applicantPlease seal the envelope, sign over the seal, and mail it to Mr. Josh Mosser at 22525 Belmont Ridge Rd, Ashburn, VA 20148 or return it to the applicant. Please reference the student on the front of the envelope. Letters must be submitted by the application deadline. No Exceptions. Please talk to the NHS Candidate for the Due Date.Student Name: Writer's Name: Signature of Writer: Date: Position:Phone Number: How long have you known the applicant? Please attach a separate letter to this page to comment on this individual's service and/or leadership to your organization. Please do not use the back of this page.demonstrated. Please comment on:The applicant’s commitment to serviceThe nature of the activitiesHow this person demonstrated leadership in events or organizationsAdditional comments about the CHARACTER (honesty, reliability, etc.)of the applicantPlease seal the envelope, sign over the seal, and mail it to Mr. Josh Mosser at 22525 Belmont Ridge Rd, Ashburn, VA 20148 or return it to the applicant. Please reference the student on the front of the envelope. Letters must be submitted by the application deadline. No Exceptions. Please talk to the NHS Candidate for the Due Date.Student Name: Writer's Name: Signature of Writer: Date: Position:Phone Number: How long have you known the applicant? Please attach a separate letter to this page to comment on this individual's service and/or leadership to your organization. Please do not use the back of this page.Checklist for National Honor SocietyBriar Woods High SchoolChecklist (please complete and submit WITH your final application) Remember that your application will not be considered if you are missing any of the following from the checklist below.Did you remember to. . .Type or write the application neatly and in black ink? Did you proof your application?Did you edit (Ask a teacher to review essay for you!) and type your essays?Paper clip rather than staple the application together? Sealed in a large envelope with your name on the envelope?Make sure no items were taped or glued to the application?Make sure you have ALL necessary signatures and phone numbers?Place your letters of recommendation in a signature-sealed envelope?DUE DATE:Tuesday, October 13, 2015 by 4 p.m.Parent/Guardian and Student Consent46101012763500We have reviewed this application and the attached cover letter. We are aware of the requirements for application and recognize that failure to comply with these standards may disqualify this application. We understand the election criteria (Student Information Sheet, Attendance Record, Discipline Record, and Recommendation Letters). We also understand that students selected for the National Honor Society must attend meetings and functions as required. If accepted into NHS membership you are expected to participate in all activitiesincluding the fund raiser to help cover the costs of service projects, end of the year awards, patches, annual awards breakfast, etc. There is also membership dues explained at the first meeting. If you sign up to go on a field trip and then cancel out, you will be expected to reimburse NHS for your individual costs. THERE ARE NO EXCEPTIONS TO THIS RULE! We recognize that students will be required to perform a minimum of 30 hours of community service hours (outside of Briar Woods HS), maintain a 3.5 GPA, and may be removed from the Society for failing to meet these requirements.Student NameStudent SignatureParent NameParent Signature ................
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