Rotary Club of Omaha Honor Roll Application
Leadership….Character….Scholarship….Presence
APPLICATION January 2015
Each year, the staff at Beadle Middle School works with the Omaha Rotary Club to recognize and honor
students who embody the core qualities recognized by the Rotary Honor Roll. This year, we can
recognize 20 students (1 per 20 students.) We have created an application process that mirrors many
of the applications you will complete in your high school years – applications for jobs, college admission,
scholarships. This is a great opportunity to start practicing those skills. We hope ALL of our students
complete this application.
Directions:
1. CAREFULLY read all of the following directions.
2. You must identify one adult in your life who will serve as your nominator. Parents may not serve as your
nominator. This person needs to complete the attached Nomination Form. The nominator must write a
statement indicating how you demonstrate one or more of the values associated with the Rotary Honor
Roll – character, leadership, scholarship, and presence. The nominator may complete the form and
submit it to the office on your behalf or you may attach it to your application. The nomination and the
application must both be submitted prior to the application deadline.
3. Your completed application is due to Dr. Stevens in the main office NO LATER than 3:30 PM on
Wednesday, February 4th. Late or incomplete applications will not be considered for selection.
4. Students will be notified of their selection status by letter that will be mailed home on or prior to
February 27, 2015.
5. If you have further questions about this application, please contact Dr. Bridgette Stevens at
402.715.6103 or bbstevens@mpsomaha.org.
6. Talk to older youth or adults in your life about what makes a good application. Learn how to present
yourself in the best possible ways.
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Nomination for Rotary Honor Roll
Nominator: _____________________________________________
Relationship to applicant: ___________________________________
Directions to Nominator: In the space below please provide your endorsement for the student by
indicating how he or she demonstrates one or more of the traits recognized by the Omaha Rotary. You
may submit the form on behalf of the student by sending it to Dr. Bridgette Stevens at Beadle Middle
School (bbstevens@mpsomaha.org) or you may return it to the student who may submit it with his or
her application. The due date for applications and nominations is by 3:30pm on Wednesday, February 4,
2015.
Dear Selection Team,
I am nominating ________________________________________ for consideration to receive the
Rotary Honor Roll. In my opinion, this student demonstrates outstanding (circle one or more):
scholarship
character
leadership
presence
by: (state your evidence. How do you see this trait in the student?)
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Nominator’s Signature: _____________________________________
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Leadership….Character….Scholarship….Presence
Application Directions to the student:
Create a well-written document that includes the items outlined in the following sections. Your
application will be read and judged by a team of Beadle teachers. The names of the teacher judges will
remain confidential. The judges will NOT be given page 1 of your application which includes your
identifying information. Once you feel the document is complete, print it and submit to Dr. Stevens in
the Beadle Office.
Page 1
Identifying Information:
This section must include:
Your Name
Your School Team Name
Your Nominator’s Name
Page 2 (or more if needed)
Evidence of Achievement
In this section provide evidence that shows you possess one or more of the traits recognized by this award –
scholarship, leadership, character, and presence (how you present yourself to others.) Evidence may include but
is not limited to awards, grades, leadership positions, volunteer work, involvement with school clubs and
activities, involvement with out of school clubs and activities.
Page 3 (or more if needed)
Essay
Write a well-designed 5-paragraph essay in response to the following prompt:
In your time at Beadle, describe how you have grown in the areas of scholarship, character, leadership, and
presence.
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