Page 1 of 5 Last Name, First Name Class of ______ National Honor Society Michael E. DeBakey High School for Health Professions Membership Application 2012-2013 Membership Selection The four guiding principles of the National Honor Society are scholarship, service, leadership, and character. The Faculty Council of the DeBakey NHS will be considering all four of these principles when deciding which students will receive the honor of selection into membership. Selection into NHS requires a majority vote by the Faculty Council. Selected candidates will become members at an induction ceremony in the fall semester. Requirements BEFORE Consideration for Selection: 1. _____Insert a typed Header with your last name, first name, and graduating class 2. _____ Member of the junior or senior class for the school year of induction 3. _____ 3.7 or higher GPA (no curving) 4. _____ Good Conduct Grades No U’s No office P’s No more than 1 class P freshman year No class P’s after freshman year No more than 3 S’s after Freshman Year No record of cheating 5. _____ Application Packet STAPLED TYPE YOUR COMPLETE INFORMATION ON TO THE FORM(Adjust font size as needed) Your application will not be considered if it is handwritten (except signatures) All required signatures Both required short essays in MLA format. One page per essay STAPLED AND Turned in on time on or before Friday, May 25, 2012 The registrar and counselors will verify GPA’s, conduct grades INFORMATION PACKETS ARE DUE IN MS. JOLIVET’S ROOM NO LATER THAN 3:30 P.M. Friday, May 25, 2012 Late or incomplete application packets will not be considered. (NO EXCEPTIONS) NOTIFICATION OF SELECTION Students selected for membership in the DeBakey NHS will be notified early in the fall semester. Page 2 of 5 Last Name, First Name Class of ______ Information Submitted for Selection Consideration 2012-2013 National Honor Society Michael E. DeBakey High School for Health Professions Type or print all information neatly and legibly in blue or black ink. Last Name (First) Sex: _male Phone Numbers: , First Name (Last) _female Age: Year of Graduation _ Home Cell E-mail address Current Address Apt # (Street Number and Street Name) City , TX Parent/Guardian Phone Numbers Zip Code relationship to you Home # Cell/Work # Total Hours on record with Registrar Mr. Seaton ________________________ as of May 11, 2012 All of the information I have submitted to the NHS is truthful and complete. I understand the requirements for membership include but are not limited to the following: maintaining a 3.7 or higher GPA, maintaining exceptional conduct at all times, participating fully in NHS service projects, paying all dues, attending scheduled meetings, and behaving as a positive role model for the rest of the student body and the community. I understand that NHS membership is not a right or entitlement; it is an honor bestowed upon selected students. _________________________________________ Student’s Signature I can verify that all of the information submitted to the NHS is accurate and complete. I understand that NHS membership is not a right or entitlement, but an honor bestowed upon selected students. I understand the commitment my son or daughter is making and the duties and obligations that accompany NHS membership. _________________________________________ Parent’s/Guardian’s Signature Page 3 of 5 Last Name, First Name Class of ______ Service during your High School years only TYPED List your three most significant community service activities or organizations. These may be individual or group projects, done in or out of school. Report all service hours to the registrar with signatures. Be honest, but do not be modest. Briefly, describe what you did to make the activity successful. Service Activity or Organization Dates & # of Hours Sponsor’s Name and Phone # 1. Date Sponsor’s Name 2. Hours Date Phone # Sponsor’s Name 3. Hours Date Phone # Sponsor’s Name Hours Phone # Your Accomplishments & Contributions Leadership during your High School years only TYPED (EXCEPT SIGNATURES) List your three most significant leadership community service activities. You could have been a leader with or without holding a formal office. These examples may come from inside or outside of school. Be honest, but do not be modest. Briefly, describe what you did to help make the activity or the organization successful. Activity or Organization Dates Involved & # of Hours Sponsor’s Name, Phone #, & Signature 1. Date Name: Phone #: 2. Hours Date Signature: Name: Phone #: 3. Hours Date Signature: Name: Phone #: Hours Signature: Your Accomplishments & Contributions & Any Office(s) Held Page 4 of 5 Last Name, First Name Class of ______ Clubs, Organizations, Hobbies, etc. during your High School years only TYPED List your three most significant activities, clubs, organizations, or hobbies. These may come from inside or outside of school. Sponsor’s Name Activity or Dates Your Accomplishments & Contributions Organization Involved & # of Hours Phone # 1. Date Sponsor’s Name 2. Hours Date Phone # Sponsor’s Name 3. Hours Date Phone # Sponsor’s Name Hours Phone # Work and or Volunteer during your High School years only TYPED List and briefly describe any jobs you have held recently. Employer Dates Involved & Supervisor’s Name Hours per week & Phone # 1. Date Supervisor’s Name 2. Hours Date Phone # Supervisor’s Name 3. Hours Date Phone # Supervisor’s Name Hours Phone # Your Job Responsibilities & Contributions Page 5 of 5 Last Name, First Name Class of ______ 2 Short Essays Separate Pages MLA Title Font Size 12 Times New Roman Doubled Spaced Correct paragraph indention (if more than one paragraph) One inch margins Five to eight sentences First Person point-of-view Format Type your required responses to both of the following prompts using MLA format (12-point font, double-spaced, one-inch margins). Each short essay should be only 5-8 sentences. Attach your essays to this information packet. Use first person point-of-view. Evaluation Criteria Essays will be judged on the following: Meaningful content Scholarship: -Grammar, punctuation, spelling, capitalization -Organized, logical, coherent -Varied and complex sentence structures -Diction -format Service Prompt Write a concise, 1-paragraph essay of 5-8 sentences explaining one significant lesson that you have learned through a community service to others. This may be a lesson gained through regular community service or informal service to others, such as caring for a handicapped sibling or tutoring your friends in physics. Leadership Prompt Write a concise, 1-paragraph essay of 5-8 sentences explaining one example of how you have demonstrated true leadership with a community service project. This is not about holding an office. This is not about doing all of the work. This is about truly leading others to accomplish something meaningful. You may have been a leader with a formal title and office, or you may have been a leader without holding office. Stick to what you did, how you did it, and why you did it that way. Do not include quotes and philosophies of others within your sentences. “Optional” Faculty Council will review the applications. If you feel Faculty Council needs information regarding possible negative information about you, you may type a succinct explanation of the mitigating circumstances behind the incident in question and attach it to your application.