National Honor Society Candidate
Student Information Activity Form
I. Administrative Information
Name _______________________________________________
Current Grade Level ______
Current Non-weighted Cumulative GPA________
Directions: Please complete ALL sections. Word process all information and submit it by the published deadline. Do not be modest.
Every bit of information will be used by the faculty council to assist with the fair consideration of your candidacy during the selection
process. PLEASE only include information from 9th grade to current.
Completion and submission of the form does not guarantee selection. Should you have questions about this form, please contact Rita Leonard
at rita.leonard@isd624.org.
II. Service/Community Activities/Leadership-List service/community/leadership activities in which you have participated. These can be
individual or group service projects done with a group either in or out of school or done as individuals performing service. Generally, service
activities are those that are done for or on behalf of others (not including immediate family members) for which no compensation (monetary or
otherwise) has been given. Please ask an adult supervisor (not parents) who can verify your participation in each activity to sign on the
appropriate line, and also list the estimated number of hours you invested while performing this service.
List all elected or appointed leadership positions of responsibility held in school, community, or work activities. Only those positions in which
you were responsible for directing or motivating others should be included (e.g. elected officer for the student body, class, or club; committee
chair person; team captain; newspaper editor; work area manager; or other community leader).
Activity
Grade Hours of
Leadership
Level(s) Service/Week Role
Supervising Adult
Print Name
Signature of person to verify activity
Include Phone #
Print
Signature
Phone#
Print
Signature
Phone #
Print
Signature
Phone#
Print
Signature
Phone#
Print
Signature
Phone #
Print
Signature
Phone #
III. Other Student Activities/Extra-Curricular/Awards/Recognition-List all other in school and out of school activities (not noted above) in which
you have participated in. Include clubs, teams, musical groups, etc., and any significant accomplishments in each that you would like the Faculty
Council to be aware of.
Activity/Awards/Recognition Grade Accomplishments Leadership
Level(s)
Role
IV. Signatures
I understand that completing and submitting this form does not guarantee selection to the 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 chapter and to fulfill all of my
membership obligations to the best of my ability.
Student Signature
Date
I/we have reviewed the full Candidate Information Packet provided to us by the chapter. In addition, I/we have read the information submitted
by my son/daughter on this form and can verify that it is true, accurate, and complete.
Parent Signature ________________________________________ Date: ________________________
National Honor Society Essay Requirements
1. Explain why you want to be a member of the National Honor Society.
2. As a prospective member of the National Honor Society, you may be asked to decide on a National Honor Society Chapter leadership or
service activity. Please explain your plan of action to help your school, community or nation. Your proposal could be a specific plan to
raise money, to volunteer, to promote awareness, or any other creative solution that you have to offer.
Helpful Hints:
*Title your essay’s, there are two separate requirements.
*Neither essay should be longer than one page.
*Type your essay using 12 font and remember that computer troubles are NOT an acceptable excuse for not turning your candidate packet
in on time.
*Have someone you trust proofread for you.
STUDENT CONDUCT POLICY—Division of Student Activities
For purposes of this policy the term “association” includes the Minnesota Association of Secondary School Principals (MASSP), The
Minnesota Association of Student Councils (MASC), the Minnesota Association of Honor Societies (MAHS) and the Division of Student
Activities (DSA).
Students are prohibited from using tobacco products, alcohol, or other mood altering drugs at any association-sponsored activity, but not
limited to, workshops and conventions. In addition, student’s participation in association-sponsored activities shall abide by the rules of
conduct enacted by their home district. Under all circumstances students at association-sponsored activities shall conduct themselves in an
appropriate manner.
Violations of the above-described rules will be reported to the student’s home school and the parents of the student.
Failure to conform to the above rules may result in the following disciplinary actions:
A.
B.
C.
D.
Removal from the association-sponsored activity.
Removal from elected positions in association-sponsored organization;
Exclusion from future participation in association activities;
Other appropriate discipline.
I have read, acknowledge and understand that I must adhere to the rules and regulations when participating in activities sponsored by
the MASSP’s Division of Student Activities:
White Bear Lake Chapter of the National Honor Society.
Student Signature ___________________________________ Date _______________________
Parent Signature ____________________________________ Date ________________________
National Honor Society Candidate Packet
REQUIREMENTS
1. Complete ALL sections of the National Honor Society Candidate Student Information Activity Form. Any incomplete forms may be
rejected.
2. Complete the two essay questions. See specific guidelines in packet.
3. One letter of recommendation from someone OTHER than a South Campus teacher, parent, guardian, or any relative. Some examples of
who to ask would be: an employer, church leader, advisor of Ambassadors, a North Campus teacher or a coach. PLEASE have this letter
include the writer’s relationship to the candidate. Include this letter of recommendation with other forms.
4. Student and parent signatures on the activity form and the student conduct policy form.
DUE DATE is:
February 12, 2016 @ 12 noon
to the Counseling Office.
To access forms on line:
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Web site www.isd624.org
Our Schools Tab
WBLAHS-North/South Campus
Student Resources
General Information
National Honor Society Packet
White Bear Lake National Honor Society Selection Process
The National Honor Society Chapter of White Bear Lake is a duly chartered and affiliated chapter of this prestigious national organization.
Membership is open to those students who meet the required standards in four areas of evaluation: scholarship, leadership, service, and
character. Standards for selection are established by the national office of NHS and have been revised to meet our local chapter needs.
Students are selected to be members by a 5-member Faculty Council, appointed by the principal, which bestows this honor upon qualified
students on behalf of the faculty of our school each February/March.
Students in the 11th grade are eligible for membership. For the scholarship criterion, a student must have a non-weighted cumulative GPA of
3.33 or better on a 4.0 scale. Those students who meet this criterion are invited to complete a Student Activity Information Form that provides
the Faculty Council with information regarding the candidate’s leadership and service. A history of leadership experiences and participation in
school or community service is also required.
To evaluate a candidate’s character, the Faculty Council uses two forms of input. First, school disciplinary records are reviewed. Second,
members of the faculty are solicited for input regarding their professional reflections on a candidate’s service activities, character, and
leadership. These forms and the Student Activity Information Forms are carefully reviewed by the Faculty Council to determine membership. A
majority vote of the council is necessary for selection. Candidates are notified regarding selection or nonselection according to a predetermined
schedule.
Following notification, a banquet and formal induction ceremony is held at the school to recognize all the newly selected members. Once
inducted, new members are required to maintain the same level of performance (or better) in all four criteria that led to their selection. This
obligation includes regular attendance at chapter meetings held twice a month during the school year and 30 hours of service to the school and
community each semester. Students or parents who have questions regarding the selection process or membership obligations can contact the
chapter advisor, Ms. Rita Leonard, in room #302, e-mail rita.leonard@isd624.org or by phone #651.773.6200, extension #2251.