National Technical Honor Society
Instructor Nomination Form
Please give the completed nomination form to the student who will submit with the
application.
Name of Student Nominee: _________________________________________________
Academic Program: _______________________________________________________
Nominating
Instructor_____________________________Class/Subject________________________
Is this student interested in pursuing a career in this field of study? Yes_____ No______
List any outstanding accomplishments of the
nominee:________________________________________________________________
________________________________________________________________________
_______________________________________________________________________
List any outstanding academic or professional (career-related) qualities of the
nominee_________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Please check the appropriate answer:
Follows instructions
Yes____No____
Safety conscious
Yes____No____
Works well with others
Yes____No____
Is dependable, trustworthy, responsible, honest
Yes____No____
Takes pride in work
Yes____No____
Exhibits good attitude
Yes____No____
Exhibits leadership
Yes____No____
Exhibits good citizenship
Yes____No____
Additional comments related to the student’s qualifications for membership into the
society__________________________________________________________________
________________________________________________________________________
________________________________________________________________________
I recommend this student as member of NTHS without any reservations Yes____No____
Instructor Signature and date:
__________________________________ Date ________________________