STUDENT NAME:_____________________
STUDENT ID #__________
EGG HARBOR TOWNSHIP HIGH SCHOOL
24 HIGH SCHOOL DRIVE
EGG HARBOR TOWNSHIP, NEW JERSEY 08234-9450
(609) 653-0100
DR. TERRY CHARLTON
Principal
Ext: 1601 – Fax (609) 927-8844
CARLEENA SUPP
Assistant Principal
Ext: 1649 – Fax (609) 653-6586
DR. ALICIA SCELSO
Assistant Principal
Ext. 2686 – Fax (609) 653-6206
SHANE CHISHOLM
Assistant Principal
Ext. 1604 - Fax (609) 653-6609
GEORGE WEST
Assistant Principal
Ext. 1606 – Fax (609) 653-6328
EGG HARBOR TOWNSHIP HIGH SCHOOL
2015-2016 SENIOR AMBASSADOR APPLICATION
Dear Parent/Guardian:
Egg Harbor Township High School will be offering a Senior Ambassador program for eligible students
in the 2015-2016 school year. Up to one hundred ten (110) seniors will be selected to participate. If a student
chooses to drive, there is a $100 non-refundable parking fee per school year (check made payable to EHTHS).
To be eligible, students must have met the following criteria by the end of junior year:



Earned 100 course credits.
Satisfactory attendance and discipline record as determined by the Assistant Principal.
Academically eligible as per student handbook guidelines.
Senior Ambassadors agree to mentor an assigned group of freshmen students throughout the school year.
Mentoring will take place during teacher / staff supervised assigned study halls once per week. Therefore,
Senior Ambassadors must schedule a study hall for the 2015-2016 school year. Senior Ambassadors must also
agree to the following:






Attend three days of MANDATORY training from 9:00 am – 2:00 pm, August 10-12.
Attend Freshman Orientation August 24th (date pending Board of Education Calendar approval) from
8:00 am – 2:00 pm.
Attend Freshman Orientation August 24th (date pending Board of Education Calendar approval) evening
parent meeting.
Remain academically eligible, have no significant discipline events as determined by the administration,
and have no attendance issues throughout the school year.
Complete the Senior Ambassador Application packet that will be posted on the High School website
during the week of February 9 and discussed during scheduling by the student’s Guidance Counselor.
Submit two staff recommendations and a typed essay as follows: In 250 words or less, describe what
you feel a mentor is, and identify the qualities in yourself that would enable you to successfully
mentor a younger student.
STUDENT NAME:_____________________
STUDENT ID #__________
CHOOSE YOUR STAFF RECOMMENDATIONS WISELY!!! You may choose any staff members
in this building—but you want to make sure that the person you choose will give information that will most
accurately reflect YOU.
An informational meeting will be held on Thursday, March 12, 2015 at 6:00 pm in the High School
Auditorium to discuss the program, and answer any questions you may have. Additional information on
parking rules, regulations and expectations as well as Teen Driver Safety will be provided.
By signing this application I understand that, if approved, my child will be a “Senior
Ambassador” and therefore given a parking permit and the privilege of driving to school. A
parking permit will be issued from the Assistant Principal’s office with a number corresponding
to a space in the “Front Lot”. Parking in any other space will be considered a violation. If this
application is approved, the student and parent must sign a more detailed Driving Contract and
provide copies of: 1) Student’s Driver’s License, 2) Vehicle Registration, and 3) Proof of
Current Insurance.
This application packet is due to your child’s guidance counselor no later than April 2,
2015. Applicant must complete packet in its entirety. Staff recommendation pages must be
completed where applicable by the student and given to staff members in a timely manner for
completion and submission by April 2, 2015. Students will be informed of the
administration’s decision by May 4, 2015. If one of the three criteria listed above is in question,
the decision on an individual student may be delayed until the end of the school year.
I further understand that the decision of the faculty council that
determines who is accepted into the Senior Ambassador Program is
final and there are no appeals.
_________________________________
Student Name (Print)
_________________________________
Parent Name (Print)
_________________________________
Student Signature/Date
_________________________________
Parent Signature/Date
Recommendation #1 staff member: _______________Recommendation #2 staff member:______________
Guidance Office Certification: I certify that the above named student has earned 100 credits.
_________________________________________
Counselor/Guidance Director Signature
________________
Date
Assistant Principal Certification: I approve the above named student for further review for the Senior
Ambassador program based on student’s lack of discipline and positive attendance history.
_________________________________________
Assistant Principal Signature
________________
Date
STUDENT NAME:_____________________
STUDENT ID #__________
SENIOR AMBASSADOR STAFF RECOMMENDATION FORM
Recommendation #1
Staff member name: _____________________________________
Beginning
Developing
Accomplished
Exemplary
1
2
3
4
Listening to
Listening to
Listening to
Listening to
directions or the
directions or the directions or the
Demonstrates
directions or
concerns of
concerns of
concerns of others
ability to listen the concerns of
others reflects
others reflects reflects the highest
well.
others reflects a development and
mastery of
level of mastery of
beginning level.
movement
stated objective. stated objective.
toward mastery.
To understand
and identify
with another
Demonstrates
person’s
ability to
situation
empathize with
reflects a
others.
beginning level.
To understand
To understand To understand and
and identify with
and identify
identify with
another person’s
with another
another person’s
situation reflects
person’s
situation reflects
development and situation reflects the highest level of
movement
mastery of
mastery of stated
toward mastery. stated objective.
objective.
Reflects
Reflects a
development and
Reflects mastery
beginning level
movement
of stated
of stated
toward mastery
objective.
objective.
of stated
objective.
Reflects the
highest level of
performance.
Reflects
Reflects a
development and
Reflects mastery
movement
Demonstrates beginning level
of stated
of stated
toward mastery
initiative and
objective.
objective.
of stated
self-motivation.
objective.
Reflects the
highest level of
performance.
Demonstrates
dependability
and timeliness.
Demonstrates
ability to take
part in or
redirect group
discussions
effectively.
Reflects
Reflects a
development and
Reflects mastery
beginning level
movement
of stated
of stated
toward mastery
objective.
objective.
of stated
objective.
Reflects the
highest level of
performance.
Understands
and takes
confidentiality
seriously.
Reflects
Reflects a
development and
Reflects mastery
beginning level
movement
of stated
of stated
toward mastery
objective.
objective.
of stated
objective.
Reflects the
highest level of
performance.
What additional qualities do you think this student possesses to successfully mentor a 9th grader?
Staff Signature: _____________________________
DO NOT RETURN TO STUDENT. Please return to the Guidance Office. Thank you.
Score
STUDENT NAME:_____________________
STUDENT ID #__________
SENIOR AMBASSADOR STAFF RECOMMENDATION FORM
Recommendation #2
Staff member name: _____________________________________
Beginning
Developing
Accomplished
Exemplary
1
2
3
4
Listening to
Listening to
Listening to
Listening to
directions or the
directions or the directions or the
Demonstrates
directions or
concerns of
concerns of
concerns of others
ability to listen the concerns of
others reflects
others reflects reflects the highest
well.
others reflects a development and
mastery of
level of mastery of
beginning level.
movement
stated objective. stated objective.
toward mastery.
To understand
and identify
with another
Demonstrates
person’s
ability to
situation
empathize with
reflects a
others.
beginning level.
To understand
To understand To understand and
and identify with
and identify
identify with
another person’s
with another
another person’s
situation reflects
person’s
situation reflects
development and situation reflects the highest level of
movement
mastery of
mastery of stated
toward mastery. stated objective.
objective.
Reflects
Reflects a
development and
Reflects mastery
beginning level
movement
of stated
of stated
toward mastery
objective.
objective.
of stated
objective.
Reflects the
highest level of
performance.
Reflects
Reflects a
development and
Reflects mastery
movement
Demonstrates beginning level
of stated
of stated
toward mastery
initiative and
objective.
objective.
of stated
self-motivation.
objective.
Reflects the
highest level of
performance.
Demonstrates
dependability
and timeliness.
Demonstrates
ability to take
part in or
redirect group
discussions
effectively.
Reflects
Reflects a
development and
Reflects mastery
beginning level
movement
of stated
of stated
toward mastery
objective.
objective.
of stated
objective.
Reflects the
highest level of
performance.
Understands
and takes
confidentiality
seriously.
Reflects
Reflects a
development and
Reflects mastery
beginning level
movement
of stated
of stated
toward mastery
objective.
objective.
of stated
objective.
Reflects the
highest level of
performance.
What additional qualities do you think this student possesses to successfully mentor a 9th grader?
Staff Signature:____________________________
DO NOT RETURN TO STUDENT. Please return to the Guidance Office. Thank you.
Score