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National Honor Society Membership Application 2015-2016
Holly Springs High School
Step 1: READ APPLICATION completely. Print all information neatly.
Step 2: Eligibility
The National Honor Society is a national organization based on student scholarship as well as
demonstrated leadership and commitment to service. Character is the fourth standard on which
membership is based. Character is evaluated by the NHS committee by reviewing school disciplinary
records and teacher input.
Membership Requirements:
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Rising junior or senior
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3.6 weighted GPA
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Evidence of leadership
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Evidence of service
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Evidence of strong character
Step 3: NHS Application Checklist – Documents that must be turned in by April 1st at 2:45 pm:
1. _____ Completed Application: page 2 of the application including signatures of student and parent
2. _____ Personal Statement: page 4 of the application
3. _____ Statement of Service form: page 5 (signed by service supervisor)
4. _____ Statement of Leadership form: page 6 (signed by leadership supervisor)
5. _____ Optional statement regarding prior disciplinary infractions. Attach statement to application.
6.
_____ The above documents must be complete and submitted in a packet to
Ms. Traversi in Student Services by Wednesday, April 1st at 2:45 pm.
You do not need to request a transcript. Student Services will add a current transcript to your application.
Questions?
Contact the NHS Co-Advisor: Mrs. Felker, efelker@wcpss.net or contact a current NHS Officer:
Ryan Wing
ryanmwing@yahoo.com
Hailey Gase
haileyg714@gmail.com
Elli Woodward
kewoodward23@gmail.com
Kim Boua
valeriane@nc.rr.com
Seanee Lefferts
seanee.lefferts@yahoo.com
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National Honor Society Membership Application
Student Name: _____________________________________
Current Grade Level: ______
Student ID Number: ________________________
Email Address: _______________________________________________________
Phone Number: _______________________________________
Advisory Teacher : ___________________________
The HSHS National Honor Society is a group of motivated students of high academic standing who strive to utilize their
abilities to make a positive contribution to the community around them. Please carefully review the standards below.
NHS members must commit to each standard in order to remain in good standing. Failure to comply may result in
dismissal as outlined in the NHS Bylaws.
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Members must attend the Induction Ceremony on May 5th, 2015.
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Members may miss only one meeting per semester each year.
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Members must complete and document five (5) volunteer hours at HSHS per QUARTER.
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Members must participate in ONE NHS group service project per semester.
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Members must maintain a weighted, cumulative Grade Point Average of 3.6.
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Members must maintain good moral character.
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Applicants must be a rising junior or rising senior.
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Members are required to pay the yearly NHS dues set by the national organization in compliance
with WCPSS School Board Policy (Junior dues = $13, Senior dues = $25)
The NHS Faculty Council will select members from all qualified applicants whose completed application includes
documentation of leadership, scholarship, service, and character. Information from the application as well as input from
the entire faculty and administration will be considered in the selection process.
_____________________________________________________________________________________________________
I certify that all information I have provided in my application is original, factually correct, and honestly presented to
the best of my knowledge.
Student signature: ______________________________________
Date: _________________________
I have read the information provided by my student in this application and verify that it is his/her original
work, factually correct, and honestly presented.
Parent/Guardian signature: _________________________________
Date: ____________________
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National Honor Society Standards and Directions for completing attached documents
I.
Scholarship
Requirement: 3.6 min. weighted, cumulative GPA (transcript will be provided by Student Services)
II.
Service
Requirement and Verification: At least one example of community service demonstrating a
commitment for a substantial period of time (at least 5 hours per semester) during high school
must be documented on the “Verification Statement for Service” form. Service at school is only
permissible if it is not required service for another HSHS Club (ex. DECA, HOSA, Key Club, etc.). If
unforeseen circumstances prevent you from obtaining a signature, please contact the NHS advisor
listed on page 1 of this application. (Note: Parent, relative, or student signatures on Verification
forms are not acceptable for verification of Service; you must ask an adult advisor/supervisor to
sign the Service form.)
III.
Leadership
Requirement and Verification: A least one example of community or school leadership that
involves a continuing commitment for at least 5 hours per semester during high school to be
documented on the “Verification Statement for Leadership” form. You must use examples that are
entirely separate from the Service activities listed in Section II. If circumstances prevent you from
obtaining a signature, please contact one of the NHS advisors listed on page 1 of this application.
(Note: Parent, relative, or student signatures on Verification forms are not acceptable for
verification of Leadership; you must ask an adult advisor/supervisor to sign the Leadership form.)
IV.
Character/Integrity (will be verified by HSHS staff after consideration of discipline records)
Criteria: According to the National Honor Society Handbook, a student of character:
 Takes criticism willingly and accepts recommendations graciously
 Consistently exemplifies desirable qualities of behavior (cheerfulness, friendliness,
poise, stability)
 Upholds principles of morality and ethics
 Demonstrates the highest standards of honesty and reliability
 Cooperates by complying with school regulations concerning property, programs, office,
hall, BYOD, etc.
 Regularly shows courtesy, concern and respect for others
 Observes instructions and rules, is punctual, and faithful both inside and outside the
classroom.
 Has powers of concentration, self-discipline, and sustained attention as shown by
perseverance and application to studies
 Manifests truthfulness in acknowledging obedience o rules, avoiding cheating in student
work, and unwillingness to profit knowingly by the mistakes of others
 Actively helps rid the school of bad influences or environment
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Personal Statement: Please write a concise paragraph that describes how one of the four NHS standards is evident in
your daily activities. Please use black or blue ink.
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Student Signature: ____________________________________________________
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Verification Statement for Service
Criteria: At least one example of community or school service that involves a continuing commitment for a
substantial period of time (at least 5 hours per semester) during high school. (Service cannot be required for
another HSHS Club.)
I, _______________________________________ (student name), do affirm and avow that I did complete the
following service activity on the date(s) listed below.
Project title: __________________________________________
Date(s) of Project: _____________________________________
Approximate total time spent: ____________________________
Specific volunteer work performed: __________________________________________________________
TO BE WRITTEN BY THE STUDENT
Requirement: Submit a brief paragraph detailing your role(s) and responsibilities in the aforementioned
activity. You may type/write the information in the space provided.
__________________________________________________________________________________________
To the supervisor (who is not a parent, relative or another student): by signing this document, you are agreeing
that the student completed the activity described above as evidence of “service”. Please note that this student is
submitting an application for potential membership in the Holly Springs High School Chapter of the National Honor
Society.
Name of Coordinator/Supervisor (please print clearly) ___________________________________
Signature of Coordinator/Supervisor: ________________________________Date: ____________
Supervisor’s phone number: ______________Supervisor email: ___________________________
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Verification Statement for Leadership
Criteria: At least one example of community or school leadership that involves a continuing commitment for a
substantial period of time, at least 5 hours per project, during high school.
I, _______________________________________ (student name), do affirm and avow that I demonstrated
leadership in the following activity, in my school or community, on the date(s) listed below.
Activity title: __________________________________________
Date(s) of Activity: _____________________________________
Approximate total time spent: ____________________________
Specific leadership office/role: __________________________________________________________________
TO BE WRITTEN BY THE STUDENT
Requirement: Submit a paragraph detailing your specific position(s) and responsibilities in the
aforementioned activity and how you executed these responsibilities. You may type/write the information
in the space provided.
__________________________________________________________________________________________
To the supervisor (who is not a parent, relative or another student): by signing this document, you are agreeing
that the student completed the activity described above as evidence of “leadership”. Please note that this
student is submitting an application for potential membership in the Holly Springs High School Chapter of the
National Honor Society.
Name of Coordinator/Supervisor (please print clearly) _____________________________________
Signature of Coordinator/Supervisor: ________________________________Date: ______________
Supervisor’s phone number: ______________Supervisor email: _____________________________
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Timeline for National Honor Society Applications: Spring 2015
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March 10th: Applications available on HSHS & NHS websites and in Student Services
March 12th A lunch: Informational meeting for prospective new members in room 1706
April 1st at 2:45 pm: Application Deadline – application must be submitted to Student Services
o Your application must be given to Ms. Traversi, not left on her desk. When you submit your
application you will be given a receipt.
April 10th: Letters of invitation and letters of non-acceptance will be mailed
April 20th: Deadline for appeals (denied applicants)
o Appeals must be written and submitted to the advisor by 2:45 pm (by email or on paper)
April 24th: Responses to appeals will be emailed
May 5th: NHS New Member Induction
Applicants: Please keep this page for future reference.