The Allatoona High School
Chapter of
National Honor Society
2015 – 2016
Application Packet
(Note: Incomplete packets will not be reviewed.)
Name: ________________________________________________________________________________________
Grade: __________
Only students who have been invited to apply should complete this application. Invitations were delivered to eligible juniors
and seniors through homeroom teachers. Applications submitted by ineligible students will not be considered.
Student Application Checklist
(Initial each statement to indicate that you have read and understood it.)
Student
Initials
Task
Application form is initialed and signed by student and parent/guardian.
For evaluating the areas of service and leadership—“Activities and Accomplishments” are
complete with verifying signatures. Leadership roles are showcased, and diversity of service is
demonstrated.
“Honors and Awards” are listed, if applicable.
Essay is complete and contains examples of character. (Note: The essay should not reiterate
information that is presented elsewhere in the application.)
For evaluating the area of character—Teacher recommendation form was given to the
following ACADEMIC/CORE teacher: _____________________________________________________________
For evaluating the area of character—Teacher recommendation form was given to the
following ACADEMIC/CORE teacher: _____________________________________________________________
Application packet was turned in to Mr. Ellwood in room 1219 by Friday, August 28,
2015.
Notes About the Application Review Process
(Initial each statement to indicate that you have read and understood it.)
Student
Initials
Parent
Initials
Note
We are looking for students who go above and beyond in the areas of scholarship,
character, leadership, and service.
The area of scholarship is evaluated based on weighted grade point average. Juniors
and seniors who are invited to apply for membership in NHS have a minimum
weighted GPA of 3.9 without rounding.
The area of character is evaluated based on discipline records and two teacher
recommendations. Teacher recommendation forms must be completed by two
different academic teachers in the areas of English, math, science, social studies, or
world languages. Each teacher recommendation is worth up to 40 points. Students
who meet the character requirement for NHS will score at least 36 points on each
teacher recommendation. Qualified candidates should have minimal or no entries
on their discipline record.
The areas of service and leadership are evaluated based on the “Activities and
Accomplishments” listed on this application. An ideal candidate showcases strong
and consistent leadership roles, as well as a variety of school and community
service. An indication of longevity in some of the activities listed is important. The
essay portion of this application allows students the opportunity to discuss the
ways in which they embody the ideals of scholarship, service, leadership, and
character. Character examples should be provided in the essay, and the essay should
not reiterate information found elsewhere in the application.
Applications will be reviewed by a faculty committee, and candidates will be
selected based on a majority vote. Incomplete applications will not be considered.
Page 2 of 9
National Honor Society
Allatoona High School
(Initial each statement to indicate that you have read and understood it.)
Student
Initials
Parent
Initials
Note
Membership in the National Honor Society is based on scholarship, leadership, character, and
service. Students inducted into NHS must demonstrate outstanding qualities or contributions in
each of these areas.
To be considered for membership in NHS you must complete the application in its entirety,
and return it to Mr. Ellwood in room 1219 no later than Friday, August 28, 2015. Late
applications will not be accepted. The National Honor Society Faculty Committee will review all
information provided in the packet and then select members they believe meet the standards set
by the Allatoona Chapter. Completion of this application does not guarantee acceptance into the
Allatoona Chapter of National Honor Society.
Please supply all information requested in this packet. You will be asked to provide information
concerning your contributions to Allatoona High School and the community during your years in
high school. You will also need to ask two of your ACADEMIC/CORE teachers for letters of
recommendations (forms are attached). Students must be enrolled at Allatoona High School for
one complete semester before being considered for membership.
If accepted into Allatoona’s chapter of the National Honor Society, I will be required to attend the
induction ceremony, pay annual dues of $35, and complete 5 hours of service (including 1 NHS
event) during my first semester of membership and 10 hours of service (including 3 NHS events)
during every additional semester of membership.
If accepted into Allatoona’s chapter of the National Honor Society, I understand that my
membership is a privilege, not a right, and that my membership privileges can be revoked if I do
not maintain the high ideals of scholarship (e.g., maintaining a weighted GPA of 3.9 or higher),
leadership, character (e.g., avoiding discipline entries), and service (e.g., meeting the service
requirements for each semester of membership).
Full Name ________________________________________________________________________________________
Student ID# ____ ____ ____ ____ ____ ____ ____
Grade Level _______________
Name by which you are known __________________________________________________
Student E-mail Address: ________________________________________________________________________________________________ OR N/A
Check all that apply (if any boxes are left blank, you are not eligible to apply):
 I am currently a junior or a senior.
 My weighted GPA is 3.9 or higher.
 I began attending Allatoona before 1/1/2015 (i.e., I have attended Allatoona for at least one full semester).
 I have NO discipline.
OR
 I am providing a copy of my high school discipline record.
I understand that completing and submitting this application does not guarantee selection to the National 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 Allatoona High School 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 application and can verify that it is true,
accurate, and complete.
Parent/Guardian Signature: _____________________________________________________________________
Date: _______ / _______ / _______
Parent/Guardian Phone Number: (____ ____ ____) ____ ____ ____ - ____ ____ ____ ____ work cell home
Page 3 of 9
Activities and Accomplishments
Purpose: To evaluate LEADERSHIP and SERVICE in your school and the community.
Please select at most 8 extracurricular activities in which you have been involved. These activities should
represent your main contributions to Allatoona and the community. Every effort should be made to select
activities that represent different areas of involvement and that highlight your leadership and service.
Remember that you are being evaluated in the areas of leadership and service, so you should showcase those areas
through the activities you choose to list. An adult supervisor or sponsor must verify the activity. Parents cannot
sign off on activities. Each club, organization, or activity should only be listed once.
Club/Organization /Activity: _______________________________________________________________________________________________
Type (circle): School or Community
Time Commitment:
Sponsor/Supervisor: ______________________________________________________
________ hours/week
________ weeks/year
Grade(s): 9 10 11 12
Explain your contribution: __________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Leadership Position Held:
Grade(s) Position Was Held:
_________________________________________________________________________________________
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Verifying signature: ___________________________________________________________
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Phone: _________________________________
Club/Organization /Activity: _______________________________________________________________________________________________
Type (circle): School or Community
Time Commitment:
Sponsor/Supervisor: ______________________________________________________
________ hours/week
________ weeks/year
Grade(s): 9 10 11 12
Explain your contribution: __________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Leadership Position Held:
Grade(s) Position Was Held:
_________________________________________________________________________________________
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Verifying signature: ___________________________________________________________
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11
12
Phone: _________________________________
Club/Organization /Activity: _______________________________________________________________________________________________
Type (circle): School or Community
Time Commitment:
Sponsor/Supervisor: ______________________________________________________
________ hours/week
________ weeks/year
Grade(s): 9 10 11 12
Explain your contribution: __________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Leadership Position Held:
Grade(s) Position Was Held:
_________________________________________________________________________________________
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Verifying signature: ___________________________________________________________
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Phone: _________________________________
Club/Organization /Activity: _______________________________________________________________________________________________
Type (circle): School or Community
Time Commitment:
Sponsor/Supervisor: ______________________________________________________
________ hours/week
________ weeks/year
Grade(s): 9 10 11 12
Explain your contribution: __________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Leadership Position Held:
Grade(s) Position Was Held:
_________________________________________________________________________________________
9
Verifying signature: ___________________________________________________________
10
11
12
Phone: _________________________________
Club/Organization /Activity: _______________________________________________________________________________________________
Type (circle): School or Community
Time Commitment:
Sponsor/Supervisor: ______________________________________________________
________ hours/week
________ weeks/year
Grade(s): 9 10 11 12
Explain your contribution: __________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Leadership Position Held:
Grade(s) Position Was Held:
_________________________________________________________________________________________
9
Verifying signature: ___________________________________________________________
10
11
12
Phone: _________________________________
Club/Organization /Activity: _______________________________________________________________________________________________
Type (circle): School or Community
Time Commitment:
Sponsor/Supervisor: ______________________________________________________
________ hours/week
________ weeks/year
Grade(s): 9 10 11 12
Explain your contribution: __________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Leadership Position Held:
Grade(s) Position Was Held:
_________________________________________________________________________________________
9
Verifying signature: ___________________________________________________________
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Phone: _________________________________
Club/Organization /Activity: _______________________________________________________________________________________________
Type (circle): School or Community
Time Commitment:
Sponsor/Supervisor: ______________________________________________________
________ hours/week
________ weeks/year
Grade(s): 9 10 11 12
Explain your contribution: __________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Leadership Position Held:
Grade(s) Position Was Held:
_________________________________________________________________________________________
9
Verifying signature: ___________________________________________________________
10
11
12
Phone: _________________________________
Club/Organization /Activity: _______________________________________________________________________________________________
Type (circle): School or Community
Time Commitment:
Sponsor/Supervisor: ______________________________________________________
________ hours/week
________ weeks/year
Grade(s): 9 10 11 12
Explain your contribution: __________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Leadership Position Held:
Grade(s) Position Was Held:
_________________________________________________________________________________________
9
Verifying signature: ___________________________________________________________
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Phone: _________________________________
Honors and Awards
Please list below any honors or awards you have received during high school.
Honor or Award
Year
______________________________________________________________________________________________
__________________________
______________________________________________________________________________________________
__________________________
______________________________________________________________________________________________
__________________________
______________________________________________________________________________________________
__________________________
______________________________________________________________________________________________
__________________________
______________________________________________________________________________________________
__________________________
______________________________________________________________________________________________
__________________________
______________________________________________________________________________________________
__________________________
Page 6 of 9
Essay
In the space provided, elaborate on the ways in which you embody the ideals of the National Honor Society,
particularly in the areas of leadership, service, and character. This is your opportunity to demonstrate with
certainty that you meet, if not exceed, the expectations of the ideal NHS candidate. Additional pages are not
allowed. Do not reiterate information that has been stated elsewhere in the application. Examples of character are
desired.
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Page 7 of 9
National Honor Society
CORE Teacher Recommendation Form
Purpose: To evaluate the area of CHARACTER.
Candidate’s name: ____________________________________________________
Dear (Teacher’s Name) ______________________________________________,
The student named above has achieved a grade point average that makes him or her eligible for
induction into National Honor Society. The purpose of this Society is to recognize students who combine
scholarship with leadership, service, and good character. Please take some time to rate him or her in
comparison to other students you have encountered (1 is the lowest possible ranking, and 4 is the
highest). In order for this student to be considered as a candidate, please return this form to Mr.
Ellwood’s mailbox by Friday, August 28, 2015. Your answers will remain confidential, so please be
honest. Thank you for your help.
Your score for this student…
1 = Below average
2 = Average
3 = Above average
4 = Outstanding
This student…
Takes criticism willingly and accepts my recommendations graciously.
Has a positive attitude, is cheerful, friendly, and polite.
Is punctual to class and obeys school rules.
Is honest and reliable, and respects my boundaries.
Respects other students and their property and feelings.
Shows ability to concentrate and focus on the task at hand.
Demonstrates high standards of honesty and reliability.
Inspires positive behavior in other students.
Is respected by peers and teachers.
Is resourceful in applying principles and making suggestions.
STUDENT’S TOTAL SCORE
Do you have any reservations about this student’s inclusion in NHS? If so, please comment here.
Do you know of any factors of which we should be aware as we consider this student (family situation,
after-school jobs or activities, etc.)?
Signature: ____________________________________________________________
Page 8 of 9
Date: _______/_______/_______
National Honor Society
CORE Teacher Recommendation Form
Purpose: To evaluate the area of CHARACTER.
Candidate’s name: ____________________________________________________
Dear (Teacher’s Name) ______________________________________________,
The student named above has achieved a grade point average that makes him or her eligible for
induction into National Honor Society. The purpose of this Society is to recognize students who combine
scholarship with leadership, service, and good character. Please take some time to rate him or her in
comparison to other students you have encountered (1 is the lowest possible ranking, and 4 is the
highest). In order for this student to be considered as a candidate, please return this form to Mr.
Ellwood’s mailbox by Friday, August 28, 2015. Your answers will remain confidential, so please be
honest. Thank you for your help.
Your score for this student…
1 = Below average
2 = Average
3 = Above average
4 = Outstanding
This student…
Takes criticism willingly and accepts my recommendations graciously.
Has a positive attitude, is cheerful, friendly, and polite.
Is punctual to class and obeys school rules.
Is honest and reliable, and respects my boundaries.
Respects other students and their property and feelings.
Shows ability to concentrate and focus on the task at hand.
Demonstrates high standards of honesty and reliability.
Inspires positive behavior in other students.
Is respected by peers and teachers.
Is resourceful in applying principles and making suggestions.
STUDENT’S TOTAL SCORE
Do you have any reservations about this student’s inclusion in NHS? If so, please comment here.
Do you know of any factors of which we should be aware as we consider this student (family situation,
after-school jobs or activities, etc.)?
Signature: ____________________________________________________________
Page 9 of 9
Date: _______/_______/_______