NATIONAL HONOR SOCIETY APPLICATION
MIYAMURA HIGH SCHOOL
Student Name: _
__ Grade____________
All students must have a 3.5 Grade Point Average to be eligible.
Membership in the National Honor Society is one of the highest awards our school can extend to
a student. In evaluating a student’s candidacy for the honor, all aspects of the student’s school
academia performance and behavior are considered:
A student who qualifies for candidacy based on academic performance (GPA) is then evaluated
and passed or rejected by the faculty council on the basis of:
Leadership
Character
Service
Scholarship
The National Honor Society Constitution calls for a faculty council vote for each candidate by
ballot with 75% required for membership.
Please complete all sections of this application. Please type all information. Have a
parent/guardian sign the application and return to Miss Scott in 225 no later than Friday
after school. January 8, 2015
Reminder: It is your responsibility to check to see if the people you ask to
send in recommendations did. If they are not all turned in, the application is
incomplete. Provide your recommender an envelope to turn in your
recommendations. Recommendations should be place in Miss Julie Scott’s
inbox in the teacher’s lounge. Please let your recommender know.
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Application for National Honor Society Membership
MIYAMURA HIGH SCHOOL
****To learn about National Honor Society go to http://www.nhs.us/s_nhs/index.asp***
Directions: Please complete all sections. Please type or print neatly. List all activities;
Faculty Council will consider all the information as part of the evaluation process.
Completion of this form does not guarantee selection.
Part 1: Administrative Information
Full Name______________________________________________________________
Email (please type or print neatly) _________________________________________
Home Address__________________________________________________________
Phone number___________________________________________________________
Part 2: Extra-curricular activities-List all activities, inside or outside the school, in which you
have participated during high school. Include clubs, teams, musical groups, sports etc. Indicate
in which grade you participated in each activity mentioned in
column 2.
Column 1
Activity
Column 2
Grade
9
10
11
Column 3
Advisor/ Coach/adult
supervisor's Name
12
Column 4
Contact Information
(Phone number or
email) of the person
listed in column 3
____________________________________________________________________
Print one of the advisor/coach/adult supervisor's name (from column 3) here
_______________________________________________________________________
Signature of the person listed above
Date
2
Part 3: Leadership Positions- List all elected or appointed leadership positions held in school,
community or work activities. Include only those positions in which you were directly
responsible for directing or motivating others. A student who exercises leadership is:
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Resourceful in proposing new solutions, applying principles, and offering creative
suggestions
Demonstrates initiative in promoting school activities
Exercises positive influence on peers in upholding school ideals
Contributes ideas that improve the civic life of the school
Delegates responsibilities to others
Exemplifies positive attitudes
Inspires positive behavior in others
Demonstrates academic initiative
Successfully holds school offices or positions of responsibility; conducts business effectively
and efficiently; demonstrates reliability and dependability
Is a leader in the classroom and in other school or community activities
Is willing to uphold scholarship and maintain a loyal school attitude
Column 1
Activity
Column 2
Grade
9
10
11
Column 3
Accomplishments/
Positions held
Column 4
Advisor/ Coach/adult
supervisor's Name
12
______________________________________________________________________
Print one of the advisor/coach/adult supervisor's name (from column 4) here
_______________________________________________________________________
Contact Information of the person listed above
_______________________________________________________________________
Signature of the person listed above
Date
3
Part 4: Service activities-Service generally includes those actions undertaken by the student that
are done with, or on behalf of others without any direct financial or material compensation to the
individual performing the service. In considering service, the candidate's contributions to the
school, to classmates, and to the community are reviewed. The student who performs service:
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Volunteers and provides dependable and well-organized assistance, is gladly available, and is
willing to sacrifice to offer assistance.
Works well with others and is willing to take on difficult or inconspicuous responsibilities
Cheerfully and enthusiastically renders any requested service to the school
Is willing to represent the class or school in inter-class and inter-scholastic competition
Does committee and staff work without complaint
Participates in some activity outside of school, for example: Girl Scouts, Boy Scouts, church
or temple groups, volunteer services for the elderly, poor, or disadvantaged, etc.
Shows courtesy by assisting visitors, teachers, and students
Column 1
Service
Column 2
Grade
9
10
11
Column 3
Advisor/ Coach/adult
supervisor's Name
12
Column 4
Contact Information
(Phone number or
email) of the person
listed in column 3
___________________________________________________________________
Print one of the advisor/coach/adult supervisor's name (from column 3) here
_______________________________________________________________________
Signature of the person listed above
Date
Part 5: Character-The National Honor Society is a member of the Character Counts!
Coalition. A person of character demonstrates the following six qualities: respect, responsibility,
trustworthiness, fairness, caring, and citizenship. The Faculty Council, which elects new
National Honor Society members, looks at the following characteristics of a student:
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Takes criticism willingly and accepts recommendations graciously
Consistently exemplifies desirable qualities of behavior (i.e. cheerfulness, friendliness, poise,
stability)
Upholds principles of morality and ethics
Complies with school regulations concerning property, programs, office, etc.
Demonstrates the highest standards of honesty and reliability
Regularly shows courtesy, concern, and respect for others
Observes instructions and rules, is punctual and faithful both inside and outside of the
classroom
Has powers of concentration, self-discipline, and sustained attention as shown by
perseverance and application to studies
Manifests truthfulness in acknowledging obedience to rules, avoiding cheating in written
work, and showing willingness not to profit by mistakes of either self or others
Actively helps the school to eliminate the negative influences to the environment
Part 6 Scholarship: Briefly describe, in one paragraph, at least 500 words in MLA format, how
you have demonstrated the qualities of leadership, character and service and why you wish to
join National Honor Society.
Ask four (4) of your adult supervisors / teachers / coaches to fill out the recommendation
Make four copies of the recommendation letter and
directions to handout to the person you are asking a
recommendation. Also, give them an envelope to put your
recommendation in.
form for Part 7.
Note: All criteria of Leadership, Character, and Service are reproduced from the National
Honor Society Handbook pertaining to selection.
***********************************************************************
I understand that completing this form does not guarantee selection to the National Honor
Society and that the information presented here is accurate. I also understand that the criteria
presented for selection is the same criteria that I would be expected to maintain as a member of
the National Honor Society.
_____________________________________________________________________
Student's Name and Signature
Date
I have read the information provided by my son/daughter on this form and can verify that it is
true, accurate, and complete in its presentation.
_____________________________________________________________________
Parent/ Guardian Name and Signature
Date
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Part 7
RECOMMENDER-- PLEASE RETURN THIS PORTION ONLY. If needed, use back of
form for your evaluation.
Student name_________________________________________________________
How do you know this student? ___________________________________________
_____________________________________________________________________
LEADERSHIP GRADE: _____
Remarks:
SERVICE GRADE: _____
Remarks:
CHARACTER GRADE: _____
Remarks:
General Comments:
________________________________________________________________________
Name (please print)
E-mail and Telephone Number
________________________________________________________________________
Signature
Date
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Guidelines for Faculty/ Adult Evaluations Regarding Student Candidacy for Membership in the National Honor
Society
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Please return form to student or advisor as soon as possible in a SEALED ENVELOPE bearing your signature across the seal.
If you feel competent to judge on only one or two of the qualities, do so.

Not all students will be selected. Grade the student from 1 to 4 according to the scale below :
2 = average in qualities listed below and not especially worthy
of membership
1 = weak in qualities listed below and not worthy of
consideration
4 = very superior in qualities listed below and highly worthy
of membership
3 = superior in qualities listed below and worthy of
consideration
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If you have any knowledge of any trait which would make a student an undesirable member of the society please explain under
"Remarks"
Please make comments freely, both pro and con, but only for character, leadership and service as scholarship has already been
established.
Please consider the following criteria for your judgment-
Leadership
 Resourceful in proposing new solutions, applying principles,
and offering creative suggestions
 Demonstrates initiative in promoting school activities
 Exercises positive influence on peers in upholding school
ideals
 Contributes ideas that improve the civic life of the school
 Delegates responsibilities to others
 Exemplifies positive attitudes
 Inspires positive behavior in others




Service
 Volunteers and provides dependable and well-organized
assistance, is gladly available, and is willing to sacrifice to
offer assistance.
 Works well with others and is willing to take on difficult or
inconspicuous responsibilities
 Cheerfully and enthusiastically renders any requested service
to the school
 Is willing to represent the class or school in inter-class and
inter-scholastic competition



Character Takes criticism willingly and accepts recommendations
graciously
 Consistently exemplifies desirable qualities of behavior (i.e.
cheerfulness, friendliness, poise, stability)
 Upholds principles of morality and ethics
 Complies with school regulations concerning property,
programs, office, etc.
 Demonstrates the highest standards of honesty and reliability
 Regularly shows courtesy, concern, and respect for others




Demonstrates academic initiative
Successfully holds school offices or positions of
responsibility; conducts business effectively and efficiently;
demonstrates reliability and dependability
Is a leader in the classroom and in other school or
community activities
Is willing to uphold scholarship and maintain a loyal school
attitude
Does committee and staff work without complaint
Participates in some activity outside of school, for example:
Girl Scouts, Boy Scouts, church or temple groups, volunteer
services for the elderly, poor, or disadvantaged, etc.
Shows courtesy by assisting visitors, teachers, and students
Observes instructions and rules, is punctual and faithful both
inside and outside of the classroom
Has powers of concentration, self-discipline, and sustained
attention as shown by perseverance and application to studies
Manifests truthfulness in acknowledging obedience to rules,
avoiding cheating in written work, and showing willingness
not to profit by mistakes of either self or others
Actively helps the school to eliminate the negative influences
to the environment
Note: All criteria of Leadership, Character, and Service are reproduced from the National Honor Society Handbook pertaining to
selection.
Questions? Concerns? Please contact:
Julie Scott NHS Advisor
Room 225
505-721-2047
jscott@gmcs.k12.nm.us
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