National Honor Society Student Application
Name
Grade
Ram Prep Teacher
The criteria for election to the National Honor Society are:
Scholarship
Character
Leadership
Service
You have met the standard of scholarship. The standards of character, leadership and service will
now be reviewed in a variety of ways (this packet, the WVHS faculty, the NHS faculty selection
committee).
Complete the application form provided.
• Applications must be typed
• Use only the space provided, which means you may have to prioritize what service and activities you
include.
• Write (yes, that means TYPE!) the essay.
• Make sure you and a parent read and sign the membership requirements form, and attach to the
front of the application packet.
• Find two teachers to complete a recommendation form. Do this early, so they will have time to
complete it. They will return this form directly to Ms. Chicken.
Turn in to Ms Chicken, in this order (top to bottom)
 Honor Society Membership Requirements and Signature Page
 Activities Overview
 Personal Statement
THE DEADLINE FOR TURNING IN THIS PACKET TO Ms. Chicken in room
2115 IS 3:00 PM, Friday, SEPTEMBER 4, 2015
NO LATE APPLICATIONS WILL BE ACCEPTED. All applications MUST be
turned in by the student, in person, to Ms. Chicken. DO NOT put
applications into her box.
Honor Society Membership Requirements and Signature Page
2015-2016 School Year
In order to maintain membership in National Honor Society and earn an honor cord, members must:
JUNIORS and NEW Seniors
 Maintain a 3.6 gpa
 Uphold high standards of character (no discipline reports or unexcused absences)
 Complete 15 hours of HONOR SOCIETY service
 Attend 75% of club meetings
What counts for Honor Society Activities?
 Blood Drives
 Fundraising for Honor Society
 Tutoring (no longer a requirement, but optional)
 Specific Honor Society Events—Greenway cleanup, leaf rakes, etc.
What doesn’t count towards membership and honor cords?
 Everything non-Honor Society related. Please, do community service; it just won’t count towards Honor Society.
What if I’m Running Start, an Athlete, or have a job:
While we would love to have you in our club, if you unable to make the commitment and meet the membership
requirements, then maybe Honor Society isn’t a good fit for you.
We WILL have an early-morning meeting on club days at 7:15 sharp for those of you who can’t make club times. That
will be the only flexibility in the requirement next year.
Signatures
I understand the expectations and requirements for membership set forth above. I understand that if I am unable to
meet the minimal requirements of the club, my membership will be revoked and I will be unable to reapply. By signing
this document, I also understand that an application does not mean acceptance into National Honor Society.
_______________________________________________________________________
Student Signature
PARENT REVIEW AND CONSENT:
I have reviewed my son/daughter’s application and affirm that it is correct. I
give my consent for my son/daughter to apply for membership in the West Valley Chapter of the National Honor Society.
_______________________________________________________________________
Parent Signature
Activities Overview
EXTRACURRICULAR ACTIVITIES
(Please list your principal extracurricular activities in the order of their interest to you. Include specific events and/or
major accomplishments such as musical instrument played, varsity letters earned, etc. Do not exceed the space
provided)
Dates
Activity
Description
Positions held
ACADEMIC HONORS AND LEADERSHIP AWARDS
(Briefly describe any other scholastic distinctions or leadership honors you have won or earned beginning with ninth grade,
such as science fairs or departmental awards. Please limit your response to the space provided)
Grade
Description of Award
COMMUNITY SERVICE
(Include activities undertaken which were done on behalf of others without any material compensation to the individual
performing the service.)
Date
Activity
Organization
OTHER ACTIVITIES, HOBBIES, WORK EXPERIENCE
Dates
Description
Number of Hours
Personal Statement
This personal statement is a very important part of this application in that it helps us become
acquainted with you in ways different from courses, grades, test scores, and other objective
data. It enables you to demonstrate your ability to organize thoughts and express yourself. Use
only the space provided. This essay must be typed, but it can be single-spaced. Erase these
instructions, but do not go beyond this page, including your signature. A good rule of thumb is
that you are given a page to write, so you should write a page. Appearances count—address
the prompt, provide specific examples, and edit your work.
Please address how you meet the character and leadership standards of National Honor Society
that are written below. Provide specific examples from your history as evidence that you meet
and/or exceed these standards.
Leadership: Student leaders are those who are resourceful, good problem solvers, promoters of
school activities, idea-contributors, dependable, and persons who exemplify positive attitudes
about life. Leadership experiences can be drawn from school or community activities while
working with or for others.
Character
The student of good character upholds principles of morality and ethics, is cooperative,
demonstrates high standards of honesty and reliability, shows courtesy, concern, and respect for
others, and generally maintains a good and clean lifestyle.
My signature below indicates that all information in my application is complete, factually correct, and honestly
presented.
Signature
Date
Teacher Recommendation Form:
Name of Applicant: __________________________
Dear Teacher:
In order to make sound decisions in the selection process for membership in the National Honor Society, the
Faculty Council would appreciate your candid assessment of this student. Please fill out the following chart.
If you do not feel comfortable rating the student in a particular category, please leave that row blank. Your
response should be as objective as possible.
Below Average
Average
Good (Above
Average)
Very Good (well
above average)
Exceptional (top
10%)
One of top
encountered in
mycareer
Moral and ethical
Cooperative
Honest and
reliable
Courteous
Concern for
others
Respect for
others
Appropriate
conduct
Receptive to
criticism
Honesty and
integrity
Potential for
growth
Enthusiastic
In the space below, or on a separate sheet of paper, please include any other information about this student that you think
may be helpful to the Faculty Council during the selection process.
Name:________________________________________________ Signature:___________________________________
Please return completed form to Ms. Chicken in room 2115 by Friday, September 4 th at 2:30 pm. Do not give back to the
student! These forms will remain confidential, and will be destroyed after the selection process.
Teacher Recommendation Form:
Name of Applicant: __________________________
Dear Teacher:
In order to make sound decisions in the selection process for membership in the National Honor Society, the
Faculty Council would appreciate your candid assessment of this student. Please fill out the following chart.
If you do not feel comfortable rating the student in a particular category, please leave that row blank. Your
response should be as objective as possible.
Below Average
Average
Good (Above
Average)
Very Good (well
above average)
Exceptional (top
10%)
One of top
encountered in
mycareer
Moral and ethical
Cooperative
Honest and
reliable
Courteous
Concern for
others
Respect for
others
Appropriate
conduct
Receptive to
criticism
Honesty and
integrity
Potential for
growth
Enthusiastic
In the space below, or on a separate sheet of paper, please include any other information about this student that you think
may be helpful to the Faculty Council during the selection process.
Name:________________________________________________ Signature:___________________________________
Please return completed form to Ms. Chicken in room 2115 by Friday, September 4 th at 2:30 pm. Do not give back t o the
student! These forms will remain confidential, and will be destroyed after the selection process.