National Honor Society
Formal Application
--Baldwin High School
Forrit Chapter
2012-2013
National Honor Society of Baldwin High School
Forrit Chapter
Application Checklist
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I have filled out the applicant data page correctly, signing and dating all appropriate
places.
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I have listed at least five activities and the sponsor of these activities has verified my
participation with his/her signature and phone number.
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I have listed two activities that I am currently involved with and the sponsor of these
activities has verified my participation with his/her signature and phone number.
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I have listed one on-going activity that I am involved in and the sponsor has verified
my participation with his/her signature and phone number.
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I have listed a service activity or activities in which I have obtained at least ten hours
of community service. I have provided a brief explanation including my duties and
responsibilities. The sponsor(s) has verified this service with his/her signature and
phone number.
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I have given my leadership sponsor the evaluation and labeled the envelope with my
candidate number on the front. My sponsor has returned the leadership evaluation to
me and he/she has signed across the back of the envelope.
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I have filled out the character page correctly and completely by listing my references
and their positions.
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I have given my teachers the character reference forms and labeled the envelope with
my candidate number on the front. My teachers have returned the character reference
forms to me and he/she has signed across the back of the envelope.
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I have completed the essays to the best of my ability following standard PSSA writing
procedures.
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I know that my application will be evaluated on my ability to follow directions. Any
missing or incomplete information will negatively impact my overall score in the
evaluation process.
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I will submit my application to the National Honor Society for consideration, as per
the date stated in the PowerPoint.
Late applications will not be accepted.
National Honor Society of Baldwin High School
Forrit Chapter
Applicant Data
Name: _________________________________________ Grade: _____________
Address: ___________________________________________________________
Home phone number: _______________________
Guidance Counselor: ________________________________
I verify that all of the information included in this packet is accurate. I understand and will
abide by the application procedures for the National Honor Society. I realize that a failure
to follow any part of the application procedures may lead to disqualification of my
candidacy. I also understand that completing this application form does not guarantee
selection to NHS. I understand that my application will be reviewed by the NHS Selection
Committee, comprised of seven faculty members and an administrator, and that the decisions
of the committee are final.
Student signature: _________________________________ Date: _____________
I have read the information provided by my son/daughter on this application form and can
verify that it is true, accurate, and complete in its presentation.
Parent signature: __________________________________ Date: _____________
Please label the top of each page with the following candidate number. Do not put your
name on any part of this application except on this page.
Candidate number: ___________
Candidate # ____________
Page 1
National Honor Society of Baldwin High School
Forrit Chapter
Activities Information
Definition: An activity is identified as any organized extra-curricular activity in the school and/or religious
community, in which the student has or has had active membership or participation, including clubs, teams,
musical groups, church groups, Boy or Girl Scouts, or any club sponsored outside the school. To eliminate
confusion, ninth grade football, junior varsity football, and varsity football are all one activity. This applies
to any sport. Paid positions are jobs and do not qualify.
Total Activities: The candidate is required to actively participate in a minimum of five (5) activities during
grades 9 through date of application. Please list your activities along with the years of participation. You
must have sponsors verify your participation with their signature. Verification is required. Counselor
signatures will not be accepted, unless he/she is a sponsor of that activity.
Year
*place a check
mark to indicate
all grade levels of
participation
Activity
1
2
3
4
5
6
7
8
9
10
9 10 11 12
Sponsor Signature
and Phone Number
Candidate # ______________
Page 2
National Honor Society of Baldwin High School
Forrit Chapter
Current and On-going Activities Information
Current Activities:
The candidate is required to have actively participated in two (2) activities during the current school year
(from August 31-December 31, 2009). Please list your activities and have sponsors verify your participation
with their signature. Verification is required. Counselor signatures will not be accepted, unless he/she is
a sponsor of that activity.
Activity
Dates of Participation
Place a check mark in
Start
this box if candidate is
Date still a current participant
Sponsor Signature and
Phone Number
1
2
3
On-going Activities:
During grades 9 through 12, the candidate is required to have participated in at least one (1) activity for
more than one year. Please list your activity and have sponsors verify your active participation with their
signature. Verification is required. Counselor signatures will not be accepted, unless he/she is a sponsor
of that activity.
Year
*place a check
mark to indicate
all grade levels of
participation
Activity
1
2
3
9 10 11 12
Sponsor Signature
and Phone Number
Candidate # ____________
Page 3
National Honor Society of Baldwin High School
Forrit Chapter
Service Information
Definition: Service is defined as any extra-curricular activity in an organized school, social, or religious
community, in which the student gives or has given his/her time or talents to an activity that is useful,
helpful, or beneficial to a non-profit organization. Paid positions are jobs and do not qualify.
Service activity: During grades 9 through date of application, the candidate is required to have participated
in at least 10 hours of community service. Please list the activity or activities and the approximate amount of
time that you have served. You must have sponsors verify your participation with their signature.
Verification is required. Counselor signatures will not be accepted, unless he/she is a sponsor of that
activity.
Activity
Year
9 10 11 12
Sponsor Signature
and Phone Number
Total
Hours
1
2
3
4
5
You are to provide a brief explanation in the space provided of your service including duties or
responsibilities.
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Candidate # ____________
Page 4
National Honor Society of Baldwin High School
Forrit Chapter
Leadership Information
Definition: Leadership is identified as fulfilling the position of an officer of an organization and/or
organized group leader, in which the candidate directly empowers, motivates, and organizes people to
achieve a common objective and provide moral guidance. This is not necessarily an elected position.
Examples of leadership positions are: elected student body, class, or club officer; committee chairperson;
team captain; newspaper editor; work area manager; or community leader.
For clarification purposes, leadership is not merely serving as a good role model for others in the classroom,
or in an organization or on the job. It is not sufficient to “lead by example.”
The student must have served as a leader during some time between grades nine through date of application.
Deliver the following evaluation and an envelope with your candidate number on the front of it to the
sponsor of your leadership activity. Explain the necessity of this form and the procedure that needs to be
followed. Put your name on a post-it note, attach it to the envelope, and have the sponsor complete the form
and place it in the envelope. Submit the sealed and signed envelope with your application. Be sure to
remove the post-it note that identifies you as a candidate. Do not put your name anywhere on the
evaluation form.
Position held: ______________________________________
Date or grade in which the position was held: ____________________________
Sponsor’s name ___________________________________
Sponsor’s signature: ________________________________ Phone #: ___________________
Candidate # ____________
National Honor Society of Baldwin High School
Forrit Chapter
Leadership Evaluation
Position held: ______________________________________
Date or grade in which the position was held: ____________________________
1. How does this student demonstrate leadership? (Please attach an additional sheet if necessary)
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2. A leader exhibits the following qualities. Please rate the student on a scale of 0-4
(4 being the best and 0 being the worst) Please do not leave any item blank or deem it as “not
applicable.”
___________Is resourceful in proposing new solutions, applying principles, and making suggestions
___________Exercises influence on peers in upholding positive ideals
___________Contributes ideas that improve the civic life of the school or community
___________Is able to delegate responsibilities
___________Inspires positive behavior in others
___________Demonstrates initiative
___________Successfully holds a position of responsibility, conducting business effectively and efficiently,
and without prodding, demonstrates reliability and dependability
___________Is thoroughly dependable with any responsibility accepted
Sponsor’s name ______________________________Position______________________________
Sponsor’s signature: ________________________________ Phone #: ___________________
Please enclose this form in the envelope provided. Once sealed, sign through the seal of the envelope and return
it to the student. The candidate’s number should be on the front of the envelope.
Candidate # ____________
Page 5
National Honor Society of Baldwin High School
Forrit Chapter
Essay
Directions: On a separate sheet of paper, type a clear, concise, and thoughtful essay that answers the
following prompt. The enclosed rubric will be used to evaluate your essay. It is important that your
response addresses the prompt. Off-prompt essays will not receive credit. Handwritten essays will not be
evaluated. Staple your type-written response to this form.
Prompt: Describe how you demonstrate or exemplify moral character in your academic and personal
pursuits.
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By writing your candidate number below you are acknowledging that this is your work, done to the best of
your ability. Candidate number ___________
Focus
Sharp, distinct
controlling point made
4 about a single topic with
evident awareness of
task.
Content
Organization
Substantial, specific, and/or
illustrative content
Sophisticated arrangement
demonstrating strong
of content with evident
development and
and/or subtle transitions.
sophisticated ideas.
Apparent point made
Sufficiently developed
about a single topic with
content with adequate
3
sufficient awareness of
elaboration or explanation.
task.
No apparent point but
2 evidence of a specific
topic.
1
Minimal evidence of a
topic.
0 Off-prompt=no credit
Limited content with
inadequate elaboration or
explanation.
Superficial and/or minimal
content.
Off-prompt=no credit
Functional arrangement of
content that sustains a
logical order with some
evidence of transitions.
Style
Precise, illustrative use of a
variety of words and sentence
structures to create consistent
writer's voice and tone
appropriate to audience.
Generic use of a variety of
words and sentence structures
that may or may not create a
writer's voice and tone
appropriate to audience.
Confused or inconsistent
Limited word choice and
arrangement of content with
control of sentence structures
or without attempts at
that inhibit voice and tone.
transition.
Minimal variety in word
Minimal control of content
choice and minimal control of
arrangement.
sentence structures.
Conventions
Evident control of grammar,
mechanics, spelling, usage,
and sentence formation.
Sufficient control of
grammar, mechanics,
spelling, usage, and sentence
formation.
Limited control of grammar,
mechanics, spelling, usage
and sentence formation.
Minimal control of grammar,
mechanics, spelling, usage
and sentence formation.
Candidate # ____________
Page 6
National Honor Society of Baldwin High School
Forrit Chapter
Character Information
Definition: Character is identified as those traits or qualities of moral strength, self-discipline,
fortitude, etc. that produce a pattern of personal behavior and good reputation.
Character: You are required to obtain a character reference from four teachers that you
currently have. Be sure that the instructions for the references are followed carefully. Please
list the names of your references below.
Name of Teacher
Subject Taught
Deliver the following evaluation and an envelope with your candidate number on the front of it
to four teachers that you currently have. Explain the necessity of this form and the procedure
that needs to be followed. Put your name on a post-it note, attach it to the envelope, and have the
sponsor complete the form and place it in the envelope. Submit the sealed and signed envelope
with your application. Be sure to remove the post-it note that identifies you as a candidate. Do
not put your name anywhere on the evaluation form.
National Honor Society of Baldwin High School
Forrit Chapter
Character References
Definition: Character is identified as those traits or qualities of honor, integrity, loyalty, respect,
responsibility, and resiliency that produce a pattern of personal behavior and good reputation.
The candidate is required to obtain a character reference from four teachers the student currently has.
Thank you for your time.
Candidate #:______________
Teacher: ________________________
Compared to other students in his or her class,
how do you rate this student in terms of:
(At all costs, avoid the use of N/A)
Below
Average
Average
Well
Above
Average
Excellent
(Top
10%)
One of the
top few
encountered
in my career
Integrity:



Is the student honest?
Does s/he cheat?
Does s/he have the courage to do the right thing?
Motivation:


Does the student strive to do his/her best?
Does the student exhibit a desire to achieve?
Independence, initiative:


Can the student work on his/her own without
directives?
Does the student exhibit enthusiasm for his work
and/or new projects?
Responsibility:


Is the student accountable for his/her choices?
Does s/he do what he is supposed to do?
Respect:


Does the student display respect for others, for
property?
Is s/he tolerant of differences?
Resiliency:

How does the student deal with constructive criticism?
How does the student cope with challenges?
Does the student persevere and keep trying?


Do you have any reservations about this student becoming a member of the National Honor
Society? Explain.
______________________________________________________________________________
______________________________________________________________________________
Reference Signature: ____________________________________________________________
Please enclose this form in the envelope provided. Once sealed, sign through the seal of the
envelope and return it to the student. The candidate’s number should be on the front of the
envelope.
National Honor Society of Baldwin High School
Forrit Chapter
Character References
Definition: Character is identified as those traits or qualities of honor, integrity, loyalty, respect,
responsibility, and resiliency that produce a pattern of personal behavior and good reputation.
The candidate is required to obtain a character reference from four teachers the student currently has.
Thank you for your time.
Candidate #:______________
Teacher: ________________________
Compared to other students in his or her class,
how do you rate this student in terms of:
(At all costs, avoid the use of N/A)
Below
Average
Average
Well
Above
Average
Excellent
(Top
10%)
One of the
top few
encountered
in my career
Integrity:



Is the student honest?
Does s/he cheat?
Does s/he have the courage to do the right thing?
Motivation:


Does the student strive to do his/her best?
Does the student exhibit a desire to achieve?
Independence, initiative:


Can the student work on his/her own without
directives?
Does the student exhibit enthusiasm for his work
and/or new projects?
Responsibility:


Is the student accountable for his/her choices?
Does s/he do what he is supposed to do?
Respect:


Does the student display respect for others, for
property?
Is s/he tolerant of differences?
Resiliency:

How does the student deal with constructive criticism?
How does the student cope with challenges?
Does the student persevere and keep trying?


Do you have any reservations about this student becoming a member of the National Honor
Society? Explain.
______________________________________________________________________________
______________________________________________________________________________
Reference Signature: ____________________________________________________________
Please enclose this form in the envelope provided. Once sealed, sign through the seal of the
envelope and return it to the student. The candidate’s number should be on the front of the
envelope.
National Honor Society of Baldwin High School
Forrit Chapter
Character References
Definition: Character is identified as those traits or qualities of honor, integrity, loyalty, respect,
responsibility, and resiliency that produce a pattern of personal behavior and good reputation.
The candidate is required to obtain a character reference from four teachers the student currently has.
Thank you for your time.
Candidate #:______________
Teacher: ________________________
Compared to other students in his or her class,
how do you rate this student in terms of:
(At all costs, avoid the use of N/A)
Below
Average
Average
Well
Above
Average
Excellent
(Top
10%)
One of the
top few
encountered
in my career
Integrity:



Is the student honest?
Does s/he cheat?
Does s/he have the courage to do the right thing?
Motivation:


Does the student strive to do his/her best?
Does the student exhibit a desire to achieve?
Independence, initiative:


Can the student work on his/her own without
directives?
Does the student exhibit enthusiasm for his work
and/or new projects?
Responsibility:


Is the student accountable for his/her choices?
Does s/he do what he is supposed to do?
Respect:


Does the student display respect for others, for
property?
Is s/he tolerant of differences?
Resiliency:

How does the student deal with constructive criticism?
How does the student cope with challenges?
Does the student persevere and keep trying?


Do you have any reservations about this student becoming a member of the National Honor
Society? Explain.
______________________________________________________________________________
______________________________________________________________________________
Reference Signature: ____________________________________________________________
Please enclose this form in the envelope provided. Once sealed, sign through the seal of the
envelope and return it to the student. The candidate’s number should be on the front of the
envelope.
National Honor Society of Baldwin High School
Forrit Chapter
Character References
Definition: Character is identified as those traits or qualities of honor, integrity, loyalty, respect,
responsibility, and resiliency that produce a pattern of personal behavior and good reputation.
The candidate is required to obtain a character reference from four teachers the student currently has.
Thank you for your time.
Candidate #:______________
Teacher: ________________________
Compared to other students in his or her class,
how do you rate this student in terms of:
(At all costs, avoid the use of N/A)
Below
Average
Average
Well
Above
Average
Excellent
(Top
10%)
One of the
top few
encountered
in my career
Integrity:



Is the student honest?
Does s/he cheat?
Does s/he have the courage to do the right thing?
Motivation:


Does the student strive to do his/her best?
Does the student exhibit a desire to achieve?
Independence, initiative:


Can the student work on his/her own without
directives?
Does the student exhibit enthusiasm for his work
and/or new projects?
Responsibility:


Is the student accountable for his/her choices?
Does s/he do what he is supposed to do?
Respect:


Does the student display respect for others, for
property?
Is s/he tolerant of differences?
Resiliency:

How does the student deal with constructive criticism?
How does the student cope with challenges?
Does the student persevere and keep trying?


Do you have any reservations about this student becoming a member of the National Honor
Society? Explain.
______________________________________________________________________________
______________________________________________________________________________
Reference Signature: ____________________________________________________________
Please enclose this form in the envelope provided. Once sealed, sign through the seal of the
envelope and return it to the student. The candidate’s number should be on the front of the
envelope.
Candidate # ____________
National Honor Society of Baldwin High School
Forrit Chapter
Service Project Proposal
Directions: On a separate sheet of paper, type a clear, concise, and thoughtful essay that answers
the following prompt. The enclosed rubric will be used to evaluate your response. It is
important that your response addresses the prompt. Handwritten essays will not be accepted.
Staple your type-written response to this form.
Write a detailed proposal for a community service project that can be carried out within the
National Honor Society. You may be asked to follow through with this idea next year with
fellow National Honor Society members.
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By writing your candidate number below you are acknowledging that this is your work, done to
the best of your ability. Candidate number ___________