J. Recognition & Scholarships
NC-HOSA Award Criteria and Nomination Form
American Red Cross Service Project Competition
Rex Blood Services Life Saving Project
Blood Donor Center of Cape Fear Valley
Community Blood Center of the Carolinas
Prevent Blindness
Scholarship/Recognition Opportunities
Baxley Alumni Scholarship
King’s College Application
Lunnie Yopp Service Scholarship
HOSA Foundation & Human Resources Scholarship
NCHOETA Scholarship
National HOSA Scholarships
National Recognition Program – Tips for Success
Barbara James Service Award
National Service Project
Blue Cross/Blue Shield Foundation Breast Health
Gold Star Advisor
Gold Star Chapter
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1-2
3-5
6-8
9 - 10
11 - 14
15 - 18
19
20 - 21
22 - 24
25
26 - 27
28
29
30 - 31
32 - 33
34
35 - 37
38 - 39
40 - 41
NC-HOSA AWARD CRITERIA
Honorary Life Membership
Given to an individual who has made a long-term contribution to NC-HOSA, and who is
deserving of NC-HOSA's highest honor.
VIP Award
This award is given to a person in an educational administration position who has
demonstrated outstanding support of NC-HOSA, i.e. CTE Directors, Superintendents,
Legislators, Mayors, etc.
Partnership Award
The Partnership Award is given to a person or organization outside of NC-HOSA, based
on their contribution to NC-HOSA in strengthening the "Healthy Partnership” i.e.
Hospitals, Health Agencies, Healthcare Organizations, Businesses, Local and State
Agencies, etc.
Merit Award(s)
This award is given to a person(s) within the HOSA organization or working with the
HOSA organization whose special efforts/contributions deserve recognition, i.e.
Advisors, Retired Advisors, Alumni, National Officers, Parents, Spouses, etc.
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NC-HOSA Award Nomination Form

NC-HOSA annually recognizes those individuals or groups who have made
outstanding contributions to North Carolina HOSA.

Awards include:
 Honorary Life Member
 VIP Award
 Partnership Award(s)
 Merit Award(s)

Chapters should submit a completed nomination form to NC-HOSA prior to the
conference registration deadline.

Questions? Contact the NC-HOSA State Office or Chairman of the NC-HOSA
Board of Directors. A specific description of each award and past award
recipients is included in the NC-HOSA Advisor Leadership Guide.
Nominee ________________________________________________________
Title ____________________________________________________________
Describe the nominee’s contributions to NC-HOSA. Include specific dates of
involvement and ways they have been involved with NC-HOSA.
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Chapter submitting nomination _____________________________________________
________________________________
Chapter President/Date
____________________________
Chapter Advisor/Date
*Include any additional information desired to support this nomination on a separate
piece of paper. Please attach to the form before mailing. Deadline: February 14, 2011
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Give Blood
To learn more about blood donation opportunities, visit www.givelife.org or
call 1-800-GIVE-LIFE (1-800-448-3543).
Give Blood- the Gift of Life
Want to know more about what to expect when giving blood? View our online presentation.
For more information, visit the Learn About Blood Donation section, and review the donor
eligibility guidelines.
Many generous Americans nationwide have been donating
blood since the terrorist attacks September 11 to ensure a
sustained and secure blood supply for all Americans.
Together with the Red Cross, these blood heroes are
ensuring that the safest possible blood is readily available
whenever and wherever needed - for the military, for other
blood centers in America and for all 5,000 of America's
hospitals.
We all expect blood to be there for us, but barely a fraction of those who can give do. Yet
sooner or later, virtually all of us will face a time of great vulnerability in which we will need
blood. And that time is all too often unexpected. From its beginning, the American Red Cross
has formed a community of service, of generous, strong and decent people bound by beliefs
beyond themselves. The honor, spirit and resources of the American people comes forth with
neighbors helping neighbors in need - during earthquakes, floods, fires, storms - and also for
the deeply personal and often quiet disasters that require a gift of blood.
To find out where you can donate, visit www.givelife.org or call 1-800-GIVE-LIFE (1-800-4483543).
NOTE: There are links to this site that would be beneficial when teaching the circulatory
system.
American Red Cross
www.redcross.org
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North Carolina HOSA
American Red Cross Service Project Competition
And Participation Recognition
Sponsored by the Carolina’s Blood Services Region, American Red Cross
All chapters who sponsor a bloodmobile during the competition year are
encouraged to submit an entry form so that the chapter may receive a plaque and
also be recognized by being listed in the NC HOSA State Conference Program as
an American Red Cross bloodmobile sponsor.
ELIGIBILITY AND JUDGING CRITERIA
1. Eligibility
2. Points
System
HOSA Chapter must have sponsored at least one bloodmobile during
the competitive year (February 22, 2010 – February 14, 2011).
A. (30 pts.) For each bloodmobile sponsored by the chapter during
competition year.
B. (10 pts.) If your goal for number of pints is met or exceeded.
C. (20 pts.) If the chapter wins the highest number of pints collected at a
single drive (one or two day drive).
D. (20 pts.) For each Red Cross program or project participated in a
chapter (minimum 6 students) Examples:
: CPR training
: First Aide course
: Baby Sitting course
: Disaster Training course
: Group Apheresis donation
E. (10 pts.) For each non-sponsored bloodmobile chapter assists with.
(Students can be volunteers, Recruit donors, etc)
BLOODMOBILE COMPETITION AWARDS
1.
HOSA Chapter sponsoring high school bloodmobile with the highest number
of pints collected.
2.
HOSA Chapter with the Best OVERALL PARTICIPATION with the American
Red Cross
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American Red Cross Service Project Competition
Entry Form
Chapter Name _________________________________ Advisor __________________________
School Address_______________________________________ Phone #___________________
Region ________________________
HIGH SCHOOL BLOODMOBILES SPONSORED
Date of
Blood Drive
Blood Drive
Goal
# Students
Presenting
# Pints
Collected
OTHER PARTICIPATION IN RED CROSS PROGRAMS OR PROJECTS
DATE
DESCRIPTION
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Mail this form no later than February 14, 2011 to:
OR fax: (919) 807- 3899
OR E-mail: FCress@dpi.state.nc.us
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Faye Cress, NC-HOSA
6358 Mail Service Center
Raleigh, NC 27699-6358
About Rex Blood Services
Rex Blood Services is a not-for-profit, community blood bank dedicated to
providing a safe, adequate blood supply to patients at Rex Hospital and other area
hospitals including UNC Healthcare, Duke Hospital, WakeMed, Duke Health
Raleigh (formerly Raleigh Community), Cape Fear Valley Medical Center,
Sampson Regional, and Granville Medical Center.
In 1962, Rex Blood Services began as Raleigh's first community blood donor
facility. As a member of the American Association of Blood Banks, our mission
is to provide the highest standard of care and service to area blood donors and
patients. We promote a plan of community participation to increase awareness
of the need for, and importance of, blood donation and maintenance of a
consistent and safe blood supply.
Volunteer blood donors can donate blood at the Rex Blood Services Donor
Center or on mobile blood drives set up with businesses, churches,
schools and civic organizations throughout the community
Did you know?
Every 3 seconds someone needs blood.
One donation can help save 3 lives.
Approximately 60% of our population is eligible to give blood, and only 5%
actually donate.
Donations from High Schools make up for approximately 20% of our blood
supply.
O positive and A positive are the most common blood types.
AB negative is the least common.
O negative is the universal donor blood type, able to donate to people of all
other blood types.
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North Carolina HOSA
Rex Blood Services Life Saving Project
ELIGIBILITY AND JUDGING CRITERIA
There are 4 competitive event awards and certificates of participation
for chapters sponsoring a Rex blood drive.
Point System for Life Saving Project
1. Eligibility A. HOSA chapter must have sponsored at least one blood drive during
the competitive year (February 23, 2010– February 14, 2011).
2. Point
System
A. (30pts.)
B. (20pts.)
C. (30pts.)
D. (30pts.)
E. (30pts.)
For each blood drive sponsored by the chapter during the
competitive year.
If the goal for the number of donors to present is met or
exceeded.
If the chapter wins the highest number of donors at a single
drive (one and two day drive).
If the chapter wins the highest number of pints donated at
a single drive (may be a one or two day drive).
If the chapter wins the highest number of donors to present
for the competitive year (all sponsored blood drives combined)
BLOOD DRIVE COMPETITION AWARDS
1.
Chapter sponsoring high school blood drive with the highest number of donors to
present at a single drive (one day drive).
2.
Chapter sponsoring high school that has the highest number of pints donated at
a single drive (may be a one or two day drive).
3.
Chapter sponsoring high school that has the highest number of donors to present
for the competitive year (all sponsored blood drives combined).
4.
All Chapters who sponsor 3 or more blood drives during the competitive year, will
receive a plaque from, and be recognized by, Rex Blood Services and be listed
in the NC HOSA State Conference guide.
You must submit the Entry Form by February 14, 2011 to:
Faye Cress, NC-HOSA, 6358 Mail Service Center, Raleigh, NC 27699-6358
OR Fax to (919) 807-3899 OR E-mail to fcress@dpi.state.nc.us
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Rex Blood Services Life Saving Project Competition Entry Form
Chapter Name _________________________________ Advisor _________________
School Address_____________________________________ Phone # ____________
Region ________________________
Life Saving High School Blood Drives
Date of
Blood Drive
Blood Drive
Goal
Number of Students
Registered/
to Present
Number of Pints
Collected
One Donation Can Help Save 3 Lives!
Thank you for participating in the Rex Blood Services
Life Saving Project! 
Mail this form no later than February 14, 2011 to:
Faye Cress, NC-HOSA
6358 Mail Service Center
Raleigh, NC 27699-6358
OR fax: (919) 807-3899
OR E-mail: fcress@dpi.state.nc.us
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PARTICIPATION and RECOGNITION
ELIGIBILITY AND JUDGING CRITERIA
*There are 4 competitive event awards and certificates of participation For chapters
sponsoring a blood drive.
1. Eligibility
2. Points
System
HOSA Chapter must have sponsored at least one blood drive during
the competitive year (February 23, 2010 – February 14, 2011).
A. (30pts.)
B. (20pts.)
C (30pts.)
D. (10pts.)
For each blood drive sponsored by the chapter during the
competitive year.
If the goal of number of donors to present is met or exceeded.
If chapter wins the highest number of donors for the year.
For each additional blood drive the chapter assists with
outside high school drives. (ie. an elementary or middle
school, church, etc.)
BLOOD DRIVE COMPETITION AWARDS
1. Chapter sponsoring high school blood drive with the highest number of donors to
present. (single drive).
2. Chapter sponsoring high school that has the highest number of donors to present
(all sponsored blood drives combined) for the competitive year.
3. All chapters who sponsor 1 blood drive during the competitive year, will receive a
certificate and be recognized by, The Blood Donor Center of Cape Fear Valley
Health System and be listed in the NC HOSA State Conference guide.
You must submit this Form by
February 22, 2010 to:
For more information contact:
Mary Fisher
The Blood Donor Center
Cape Fear Valley Health System
Fayetteville NC
Phone: (910) 609-6173
Faye Cress, NC-HOSA
6358 Mail Service Center
Raleigh, NC 27699-6358
OR Fax: (919) 807-3899
OR E-mail: fcress@dpi.state.nc.us
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Saving Lives, Locally
Participation and Recognition Competition Entry Form
Chapter Name ________________________________________
Advisor _____________________________________________
School Address__________________________________ Phone # _______________
Region ___________________ E-mail ______________________________________
Partners For Life - Saving Lives Locally Through High School Blood Drives
Date of
Blood Drive
Blood Drive
Goal
Number of Students
Presented
Number of Pints
Collected
Blood Donors are our community’s heroes. Thank you for your participation and your
commitment to saving lives, locally
Mail this form no later than February 14, 2011 to:
Faye Cress, NC-HOSA
6358 Mail Service Center
Raleigh, NC 27699-6358
OR fax: (919) 807-3899
OR E-mail: fcress@dpi.state.nc.us
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704-972-4700 www.cbcc.us
The Community Blood Center of the Carolinas is an independent, locally-managed,
non-profit community blood center. We provide more than 90 percent of the blood
supply to the 14 area hospitals that serve 11 North Carolina and three South Carolina
counties.
We're members of America's Blood Centers, a group of 76 independent blood centers,
which supplies 50 percent of the country's blood. We subscribe to a community-based
blood banking philosophy. That means community donors know that the blood they give
stays in that community first -- helping family members, friends and neighbors. Excess
supply is shared with other communities when needed.
Our Mission
Our mission is to be the steward of a community resource, lifesaving blood. We are
strictly a blood center, completely focused on gathering red blood cells, platelets and
plasma from volunteer donors to save local lives. Every drop of blood we collect stays
here to help people in our community.
Our Philosophy
We're members of America's Blood Centers, a group of 76 independent blood centers
that supplies 50 percent of the country's blood. We subscribe to a community-based
blood banking philosophy. That means community donors know that the blood they give
stays in our community first -- helping family members, friends and neighbors. Excess
supply is shared with other communities when needed.
Our Vision
Our vision is to build and strengthen the bonds of our community.
Why community?
The need for blood is never ending. In fact, more than 300 pints are required every day
in the treatment of our local patients. There is no substitute for life-saving blood—it
cannot be manufactured or reproduced. Yet it is essential to patients suffering from lifethreatening illnesses. CBCC collects blood from the community to use in the
community.
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PARTICIPATION and RECOGNITION
ELIGIBILITY AND JUDGING CRITERIA
*There are 2 competitive event awards for chapters sponsoring a blood drive.
1. Eligibility
2. Points
System
HOSA chapter must have sponsored at least one blood drive during
the competitive year (February 23, 2010 – February 14, 2011).
A. (30pts.)
For each blood drive sponsored by the chapter during the
competitive year.
B. (20pts.) If the goal of number of donors to present is met or exceeded.
C. (30pts.) If chapter wins the highest number of donors for the year.
D. (10pts.) For each additional blood drive the chapter assists with
outside high school drives. (ex. an elementary or middle
school, church, etc.)
BLOOD DRIVE COMPETITION AWARDS
1.
Chapter sponsoring high school blood drive with the highest number of donors to
present. (single drive).
2.
Chapter sponsoring high school that has the highest number of donors to present
(all sponsored blood drives combined) for the competitive year.
You must submit this Form by February 14, 2011 to:
Faye Cress, NC-HOSA
NC DPI – CTE
6358 Mail Service Center
Raleigh, NC 27699-6358
OR Fax to (919) 807-3899
OR E-mail to fcress@dpi.state.nc.us
For more information on sponsoring a blood drive with Community Blood Center of the
Carolinas, contact Karen Calder, Director of Development and Public Relations at 704972-4700.
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Community Blood Center of the Carolinas
Participation and Recognition Competition Entry Form
Chapter Name _________________________________ Advisor __________________________
School Address___________________________________________ Phone # _______________
District ________________________ E-mail __________________________________________
Life Saving High School Blood Drives
Date of
Blood Drive
Blood
Drive Goal
Number of Students
Registered
Number of Pints
Collected
Mail this form no later than February 14, 2011 to:
Faye Cress, NC-HOSA : 6358 Mail Service Center
Raleigh, NC 27699-6358 : or fax: (919) 807-3899:
Or E-mail to fcress@dpi.state.nc.us
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August 2010
Dear Health Occupations Teacher/HOSA Advisor:
Prevent Blindness NC is pleased to continue awarding special recognition to HOSA
chapters who participate in the vision screening certification program. The first award,
Every Youth’s Eyes Award (E.Y.E. award), is awarded to the chapter that screened the
largest percentage of elementary school students in their school district. This chapter
will receive a plaque and $100. The second award is the Healthy Eyes for Little People
Award (H.E.L.P. award). This is given to the HOSA chapter that has the best overall
participation in vision screening in their school district. This chapter will receive a
plaque.
Many HOSA chapters have a history of assisting the school nurses in vision screening
in their school districts. This partnership offers the students an opportunity to receive
skills training and become certified to screen school-age children and adults. HOSA
students offer a real service to the school nurses by freeing them up to do the other
things only the nurse can do. It also provides students with the opportunity to get
immediate feedback on what it means to help others.
In order to be eligible for the PBNC/HOSA awards, the students must be certified by
PBNC through our vision screening program. The certification training is a free 3-hour
class taught at your location. Please discuss screening opportunities with your school
nurse prior to scheduling a workshop. We limit training to classes able to participate in
mass screening in local schools.
We look forward to working with you to serve the children of North Carolina. Please call
us at 919-755-5044 or 1-800-543-7839 for more information.
Best regards,
Lisa Rawlings
Certification Program Coordinator
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2010-11 HOSA AWARDS
ELIGIBILITY AND JUDGING CRITERIA
1. Eligibility
A.
HOSA chapter must have participated in at least one mass vision screening in an
elementary school setting during competition year (7/1/10 – 2/14/11).
B.
HOSA chapter must have completed a PBNC vision screening certification class
during the current school year.
2. Judging
A.
The Every Youth’s Eyes Award (E.Y.E.) will be given to the HOSA chapter
screening the largest percentage of elementary school students in their
school district.
B.
The Healthy Eyes for Little People Award (H.E.L.P.) will be given to the HOSA
chapter with the best overall participation based on the following point system.
a) 5 points for each mass vision screening in an elementary school.
b) 5 points if the participation of certified HOSA members is at least 70%.
c) 5 points for each screening event conducted in a special setting, such as
a health fair or class project.
d) 5 points for every 100 elementary school students screened.
e) 5 points for screening over 25% of elementary school students in the
school district.
Application Procedure:
Complete the award entry forms and return to Prevent Blindness by February 14, 2011.
Winners will be announced at the annual HOSA conference in the spring.
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Prevent Blindness North Carolina Vision Screening Awards
2010-11
ENTRY FORMS
School Name:___________________________________________________________
School District:__________________________________________________________
County:_________________________Advisor/Teacher__________________________
School Address:_________________________________________________________
______________________________________________________________________
Phone:_______________________________Fax:______________________________
Every Youth’s Eyes Award (E.Y.E.)
The E.Y.E. award is given to the chapter that has screened the largest percentage of
elementary school students in their school district.
Date of Event
# of Students Screened
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Healthy Eyes for Little People Award (H.E.L.P.)
The H.E.L.P. Award is given to the chapter with the best overall participation based on a point
system.
Event
Date
# of
Students
Screened
Grade(s)
Screened
% of HOSA
Students
Participating
Return completed entry forms by FEBRUARY 14, 2011
to the address or fax number listed below:
Lisa Rawlings, Certification Coordinator
Prevent Blindness North Carolina
4011 WestChase Blvd., Ste. 225
Raleigh, NC 27607
Fax: 919-755-5013
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Event
Description
Prevent Blindness Offers
Free
3-Hr
Vision Screening
Workshops
To Schedule
A Workshop
Call
800-543-7839
PBNC promotes the
‘HOSA Model’
Collaboration
with local school nurses
in conducting mass vision screenings
in local elementary schools.
This is a great opportunity for your
students to receive hands-on experience
and provide a needed community service,
while earning a
2-year certification in vision screening.
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Scholarship Opportunities 2010– 2011
All State HOSA Scholarship applications are included in the Recognition and Scholarship
section of the Advisor Leadership Guide. Please note that there may be changes in the
some of the applications this year, please read carefully. Ask your Chapter advisors to
duplicate scholarship applications as needed
State HOSA Scholarship Opportunities Include:
$
Baxley Alumni/Post-Secondary Scholarship - *Application/qualifications were
changed to include the Post-Secondary students, send to Danny Weston at the
address on application by deadline February 14, 2011.
$
King’s College Scholarship - *Application/qualifications remain the same. This
scholarship will be given to a student planning to attend King’s College in the Medical
Assisting program. Please send to Jamie Bluto at address on application by
deadline February 14, 2011.
$
Lunnie Yopp Register Service Scholarship -*Application/qualifications remain the
same, send to Mr. Keith Register at address on application by deadline
February 14, 2011.
$
NC Healthcare Human Resources and NC HOSA Foundation Scholarship
(Use the same application/qualifications for both scholarships, check the box
for scholarship/s applicant is applying for). *Applications may be sent in with
registration to NC-HOSA State office by February 14, 2011.
$
NCHOETA –Student Scholarship – Application/Qualifications remain the same, send
application to the address on the application by the stated deadline.
$
District PALC Scholarships – Applicant must be from the designated District to apply.
Send the application to the address on the application by the stated deadline.

Please make sure you send your application/s to the correct person as we will be
unable to forward applications mistakenly sent to the State office.
National HOSA Scholarship Opportunities Include:




HOSA Scholarship
Catherine B. Junge Memorial Scholarship
Several Partnership Scholarships
Please refer to the National HOSA web site, www.hosa.org for further information
and applications for these scholarships. Deadline for National HOSA scholarships is
March 30th.





Barbara James Service Award
National Recognition Program
National Service Project
HOSA Week
Outstanding HOSA Chapter
NC-HOSA - Only
American Red Cross, Rex Blood Services, Community Blood Center of the
Carolinas, Blood Donor Center of Cape Fear Valley Health System
Gold Star Chapter
Gold Star Advisor
Recognition Opportunities 2010 - 2011



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BAXLEY ALUMNI/POST-SECONDARY SCHOLARSHIP APPLICATION
$100 Award
SUBMIT TO:
Mr. Danny Weston
P O Box 297
Kenansville, NC 28349
DUE DATE: February 14, 2011
CRITERIA
The applicant must:







Be a current HOSA Alumni or Post-Secondary/Collegiate member
Have been actively involved in HOSA prior to high school graduation
Be presently active in, or with, a local HOSA chapter
Be presently enrolled in an educational program to pursue a health career
Be deserving, in the opinion of the Health Occupations teacher or current local
HOSA advisor, of this award
Have successfully completed two Health Occupations Education courses while in
high school
Need not be present at HOSA Conference to receive the award. No interview will be
conducted for this award
BAXLEY ALUMNI SCHOLARSHIP APPLICATION
I. HOSA Alumni Member:
Name: _______________________________________________________________
Address: ______________________________________________________________
Phone: ___________________________ E-mail: ______________________________
High School: ______________________________ Advisor: _____________________
HOE Classes Taken and Grade Earned: _____________________________________
_____________________________________________ Graduation Date: __________
Career Objective or Major: ________________________________________________
___________________________________
Name of Post Secondary Institution
_______________________________
Projected Date of Graduation
II. Letter of support by local HOSA Advisor, describing why the student is deserving of
this scholarship.
___________________________________
Signature of Advisor
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_________________
Date
Page 2
Baxley Scholarship Application
DUE DATE: February 14, 2011
III. Statement by applicant as to why he/she feels they deserve the $100.00 award:
______________________________________
Signature of Student
Date
TO BE AWARDED AT THE NORTH CAROLINA HOSA STATE CONFERENCE.
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KING'S COLLEGE SCHOLARSHIP
This scholarship award, made possible by King's College, will be presented to one
outstanding HOSA member who plans to further his or her education in Medical
Assisting at King's College in Charlotte, North Carolina.
General Information
1.
The funds for this $1000 scholarship award are made possible by King's College.
One scholarship will be awarded annually, and will be applied to the tuition at
King's College in Charlotte, North Carolina.
2.
The recipient of the scholarship will be announced and presented by a
representative of King's College at the annual NC-HOSA State Conference.
Eligibility
1.
Only high school seniors who are active members of HOSA may apply.
2.
All applicants should plan to work toward a diploma or associate degree in
medical assisting at King's College in Charlotte.
3.
HOSA members applying for this scholarship may also enter another event at the
NC-HOSA State Conference.
Regulations
1.
Applications should be mailed to the Scholarship Committee at King's College as
designated on the application form.
2.
A four-part application should be completed, consisting of the following:
A.
Application form
B.
Advisor's statement
C.
Official copy of applicant's high school transcript
D.
Original essay on the importance of postsecondary education in
medical assisting. The essay should not exceed two doublespaced typed pages.
3.
Finalists will be scheduled for an interview during the annual HOSA State
Conference.
Judging
1.
Applications will be reviewed by a screening committee. Finalists must be
available for interviews at the NC-HOSA State Conference. A panel of judges,
including a representative of King's College, will conduct the interview and
determine the winner.
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KINGS'S COLLEGE SCHOLARSHIP - ADVISOR'S STATEMENT
Name of Applicant_______________________________________________________
Home Address__________________________________________________________
Name of School_________________________________________________________
School Address__________________________________________________________
(The applicant should fill in the above information.)
----------------------------------------------------------------------------------------Please complete the following information about the applicant and return this form to the
applicant.
1.
Please list the student's participation in HOSA. (Elective office, committees, meetings
attended, participation in activities.)
2.
Use the remaining space to make any other comments you wish to make.
_____________________________
Advisor's Signature
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____________
Date
King's College Scholarship
APPLICATION FORM
Please mail this application along with the essay to:
DEADLINE: February 14, 2011
Jamie Bluto, Scholarship Chairman
King's College
322 Lamar Avenue
Charlotte, NC 28204
1.
Name__________________________________________________________
Last
First
Middle
2.
High School____________________________________________________________
3.
School Address__________________________________________________________
4.
How long have you been a HOSA member? ______ Years
5.
What Health Occupations Education courses have you been enrolled in?
______________________________________________________________________
______________________________________________________________________
6.
What are your future career plans? __________________________________________
______________________________________________________________________
7.
What school and community activities do you participate in? ______________________
______________________________________________________________________
8.
Do you have a part-time job? ____ Yes
____ No
If yes, Why? ____________________________________________________________
______________________________________________________________________
9.
Will you be available for an interview at the HOSA State Conference? ____Yes ____No
10.
Is the essay you are submitting solely your own?
___________________________
Applicant Signature
_____ Yes
_____ No
___________________________
Advisor Signature
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___________
Date
LUNNIE YOPP REGISTER SERVICE SCHOLARSHIP
$200 Award
SUBMIT TO:
Keith Register
404 Pierpoint Drive
Wilmington NC 28405
DATE DUE: February 14, 2011
APPLICATION
NAME ________________________________ LOCAL CHAPTER ______________________
ADVISOR _________________________ REGION _____________ GRADE LEVEL________
NUMBER OF YEARS ENROLLED IN HEALTH OCCUPATIONS EDUCATION: _____________
NUMBER OF YEARS A MEMBER IN HOSA_________________________________________
NUMBER OF HOURS OF COMMUNITY SERVICE___________________________________
ANSWER THE FOLLOWING QUESTIONS IN 50 WORDS OR LESS:
1.
List a detailed description of your community services this year.
2.
Why do you believe community service is important?
Advisor's Confirmation: The above information is correct and true as stated by this Student.
______________________________________________________________
Signature of HOSA Advisor
Date
______________________________________________________________
Signature of Student
Date
NOTE: Selection will be made based on the content of this application. No interview is required.
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North Carolina Healthcare Human Resources Scholarship
And
North Carolina HOSA Foundation Scholarship
Eligibility Criteria
Eligibility
1. High school seniors who are active members of HOSA.
2. All applicants should plan to work toward a degree in hospital-related medical/health
care profession.
3. All applicants must provide proof of acceptance to a postsecondary or collegiate
institution before scholarship $ will be awarded. A letter of acceptance may be sent in
with application or brought to conference if available.
Procedures
1. All applicants must submit the following:
a. Completed application
b. Financial Aid Form
c. Official transcript
d. Three recommendations (HOE teacher and 2 others)
e. Resume’ of community and leadership activities for the past three years.
2. Applications received in the NC-HOSA office by the published deadline will be
screened by a committee of two (2) education consultants, one (1) area health
industry representative, and others as selected by the NC-HOSA advisor. The
committee will choose no more than 6 finalists to be interviewed at the NC-HOSA
State Conference in the spring of each year.
3. Finalists will be notified in writing of their selection for an interview at least tow week
prior to the state conference.
4. An interview committee at the NC-HOSA State Conference will make the final
scholarship selections. The interview committee will consist of individuals selected
by the NC-HOSA advisor and NC Healthcare Human Resources Association.
Criteria
Final Selection will be based upon:
A. Financial need
B. Scholastic achievement
C. Evidence of leadership ability
D. Interview
20%
30%
20%
30%
The scholarship will be announced and presented during the Awards Session at State
Conference
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 North Carolina Healthcare Human Resources Association
And
 North Carolina HOSA Foundation Scholarship
(Please check the box of scholarship/s applying for)
Scholarship Application
Name ______________________________High School ________________________
Home Address _________________________________________________________
Home Phone # _______________________Advisor: __________________________
List the Health Occupations Education courses you have taken:
Please describe your future career plans:
Signature of Applicant ___________________________________ Date ___________
With this application, please enclose:
1.
2.
3.
4.
A completed Financial aid form
An official transcript (in a sealed envelope)
Three written recommendations (HOE teacher and 2 others)
A typed resume’ of community and leadership activities for the past 3 years.
TO BE CONSIDERED FOR THIS SCHOLARSHIP, ALL INFORMATION MUST BE RECEIVED
BY THE NC-HOSA STATE OFFICE BY February 14, 2011. APPLICANTS MUST BE ABLE
TO BE PRESENT FOR AN INTERVIEW AT THE NC-HOSA STATE CONFERENCE.
J 27
North Carolina Health Occupations
Education Teachers Association
Student Scholarship Application
Name ________________________________________________________________
High School ___________________________________________________________
Home Address _________________________________________________________
Home Phone Number (
)
E-mail: _________________________
List the Health Occupations Education courses you have taken: ___________________
______________________________________________________________________
Essay: On a separate piece of paper, please describe your future career plans.
____________________________________________
Signature of Applicant
________________
Date
With this completed application please include:
1. An official school transcript.
2. A recommendation from your HOSA Advisor.
3. A typed resume of school, leadership, and community activities during your high
school career.
4. The essay listed above.
To be considered for this scholarship in the amount of $100.00, all information must be
post-marked on or before February 14, 2011. No exceptions!
Please send to:
Frances Hess
Cherokee High School
PO Box 134
Cherokee NC 28719
Scholarship recipient’s name must be forwarded to NC-HOSA by March 21, 2011.
J 28
National HOSA Scholarships
There are several scholarships available through National HOSA. Applications are
available on – line at www.hosa.org. NC-HOSA does not handle these scholarships.
The forms must be complete and submitted to National HOSA at 6021 Morriss Road,
Suite 111, Flower Mound, TX 75028 by April 1, 2011.
HCA Scholarship
HCA – Hospital Corporation of America is one of HOSA’s newest partners. Last year at
nationals they provided six $1,000.00 scholarships. The scholarships were established
to honor the memory of Phil R. Patton, Senior Vice President of Human Resources for
the Nashville-based company, who died in a plane accident in October, 2003. There
are particular forms to complete for this scholarship. Please refer to the HOSA web site
for further instructions.
ACTE-HOE Division Scholarship
ACTE-HOE Division offered $250.00 scholarships at the 2007 National Leadership
Conference. This scholarship also had particular paperwork to be completed and was
mailed to a different address. Please refer to the national HOSA web site for further
instructions.
HOSA Scholarships
There are several HOSA partners who awarded scholarships at the 2007 National
Leadership Conference.
To be eligible for a HOSA scholarship, the student must be affiliated with HOSA on all
levels, complete the necessary forms and submit them by the April 15th deadline.
Applicants are NOT required to attend the National Leadership Conference to receive
their scholarship.
Scholarships will be awarded at the 2008 National Leadership Conference in Dallas,
Texas.
Please call 1-800-321-4672 if you have any questions concerning the applications or
submission process.
J 29
HOSA National Recognition Program
TIPSfor Success
In cooperation with the National Consortium for Health Science Technology Education, HOSA’s National
Recognition Program is NEW for 2002-2003. The purpose of the event is to encourage HOSA members to
develop the skills, abilities and attitudes necessary to pursue a career in health care.
The portfolio is designed to provide students with documentation of their achievements through health
occupations/health science education and HOSA.
ULTIMATE GOAL:
This portfolio should be something the HOSA member can take to job or college interviews. It serves as
documentation of achievements and will be helpful to the student when filling out college and job applications in
the years to come. Remember that your portfolio needs to be neat and to the
point. Here are some helpful suggestions when completing your portfolio. The biggest challenge we have
seen so far is failure to follow the directions. If the criteria says "one page" do not provide two. If the criteria
asks for "who, where, what and when" be sure you provide that information.
PORTFOLIO

DO NOT use sheet protectors or tabbed dividers. They extend out from the borders of the portfolio
and do not create a professional appearance.

DO include the verification statement as the last page of the portfolio.

DO ask your chapter advisor, parent, or mentor to evaluate your portfolio, following the published
standard, before submitting it for national recognition. Their feedback can be very helpful in
assuring a professional portfolio that follows the rules and meets the standards.
LETTER OF INTRODUCTION

DO include your full name, address, and the date just as you would any formal business letter.
Pay attention to having even top, bottom, left and right margins.

DO NOT try to squeeze too much information on the page. This is an introduction Ð not your life
history.
RESUME


DO follow acceptable resume standards. You can find good examples in textbooks and online.
Use resume quality paper and a clean, neat style. There should be NO errors on your resume.
DO NOT go over the one page limit.
PROJECT

DO use an outline or summary form to provide the key facts of your project.

DO include important information such as the date, title, duration, who was involved, purpose and
results of your project. You may include important supportive information/documentation if you
wish.

DO NOT ramble on for four pages in a narrative explanation of what is wrong with the world.
WRITING SAMPLE

DO follow the directions.

DO use a pen, write neatly, and pay attention to page margins. This part of the portfolio is
designed to share what you think and how well you write.

DO NOT type or word-process the answers.

DO NOT change the amount of space. This activity is designed to make you provide a clear and
concise answer to selected questions.
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WORK-BASED LEARNING

DO follow the directions and provide a one-page summary.

DO include the important facts Ð date, time, location, mentor(s) and what you did as part of the
experience.
NOTE: A letter from the agency in which the HOSA member experienced a work-based learning environment
may be used, provided the letter provides an appropriate description.
ORAL PRESENTATION

DO include a short description that outlines who, where, what and when the speech took place.

DO include a copy of the actual speech.

DO NOT include copies of your visual aids.

DO NOT include a thank you letter from your audience.
SERVICE LEARNING

DO use a chart or outline format.

DO provide the dates, hours, location and learning outcomes. (What did you do? What did you
learn from this experience?)

DO NOT use abbreviations that the evaluator is unfamiliar with.

DO NOT include a car wash, candy sale, or other fundraising activity that is clearly not community
service.
TECHNOLOGY

DO include a brief explanation of the technology you used.

DO NOT include a disk or CD copy of your presentation.
LEADERSHIP EXPERIENCE

DO include specific dates, titles, and a short description of each leadership role.

DO NOT use abbreviations that will not be understood by the evaluator.
This information was taken from the March 2003 HOSA Magazine, Leadership section.
Please share this information with your students.
Also refer to the April 03 edition for example of students’ work for the National Recognition Program
Portfolio.
Guidelines are available at the HOSA web site, www.hosa.org, in section B.
J 31
BARBARA JAMES SERVICE AWARD
President’s Volunteer Service Award
The purpose of this award is to encourage Health Occupations/Health Science students to become
contributing members of their communities.
The Barbara James Service Award is in memory of Barbara James, 1982-83 HOSA, Inc. Board
Chairman. Her leadership skills and contributions to HOSA exemplify the caring and compassion of
HOSA members. This award in Barbara's memory seeks to recognize individual HOSA members whose
commitment to community service is worthy of recognition.
Applications for this award must be properly filled out and received by NC-HOSA by February 14, 2011
to be recognized at the state conference and received by May 1, 2011 to be reviewed and sent on the
national HOSA if everything is correct. The application forms must be signed by the state advisor so they
must come to NC-HOSA first.
The application will reflect the HOSA member's volunteer service to his or her community. Proof of the
community service MUST BE VERIFIED in an official letter, or certificate of volunteer service, from the
sponsoring organization or agency, where the volunteer service took place. When a letter is presented, it
must meet the following criteria:
• Must be on official letterhead.
• Must be signed by an organizational representative.
• Must indicate the total hours of volunteer community service.
The application will NOT be judged against other applications. HOSA members who identify approved
volunteer activities that serve the citizens of a community will receive individual recognition for their
contributions.
Examples of Approved Volunteer Service:
• Hospital/health facility volunteer
• Rescue squad volunteer
• Volunteer at Special Olympics
• Church activities that serve the community at-large
• Fundraising for charity or the community (American Red Cross, March of Dimes,
Afghanistan Children’s Fund, Salvation Army, etc.)
• Hospice volunteer
• Volunteer at a senior center
• HOSA activities that serve the community - in the community
• Community service with another volunteer agency
Examples of activities are NOT approved for this award:
• Activities at school or during school hours
• Activities done as a school assignment, even if performed outside of school hours
• Service to a church (singing in the choir, teaching Sunday School, etc.)
• Fundraising for an organization to which the member belongs
• HOSA activities that promote HOSA (parade float, fair booth, speaking at a civic
organization, etc.)
• Activities as part of the HOSA National Service Project
A committee will review the application for meeting the standards set forth in these guidelines.
Applications that are incomplete, unsigned, or do not meet the requirements will NOT be considered for
this award.
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Certificates will be awarded to all individual HOSA members who complete a minimum of fifty (50) hours
of community service from the last day of the National Leadership Conference through May 15. NLC
delegates will be recognized during the Recognition Session at the HOSA National
Leadership Conference. When the member is not an NLC delegate, the certificate will be provided to the
State Advisor.
NLC delegates who complete the Barbara James Service Award with 100 or more hours of community
service will also earn the President's Volunteer Service Award. The President's Volunteer Service
Challenge is a White House initiative which recognizes young Americans with awards and scholarships
for outstanding community service, while encouraging more young people to serve. (If the White House
withdraws or changes this award, the HOSA requirements will change accordingly.) HOSA will submit the
paperwork and pay the $2 fee for National
Leadership Conference (NLC) delegates who meet the following requirements:
• Complete 100 or more hours of volunteer community service
• Submit the BJ Service Award application with all appropriate documentation and
signatures to be received in the National Office by May 15.
• HOSA will print the President's Volunteer Service Award winners in the conference
program and pins and certificates will be distributed at the NLC.
Only NLC registered delegates are eligible for the President's Volunteer Service Award through
National HOSA.
Local advisors who wish to recognize chapter members with this award should visit
http://www.presidentialserviceawards.org for more information.
Bronze Level 100-174 hours
Silver Level
175-249 hours
Gold Level
250 hours or more
The State Advisor’s signature on the application indicates that the State Advisor reviewed the application
and agrees that the volunteer service claim meets the guideline standards.
A committee will be established by National HOSA to review applications and determine fulfillment of
criteria for recognition.
This document was taken from the Event Guidelines for the Barbara James Service Award.
Please refer to the updated competitive event guidelines for any modifications.
If you have any questions or concerns regarding volunteer activities and whether they will be allowed,
please contact Faye Cress at fcress@dpi.state.nc.us or call, 919 807-3900.
Students can apply for this award each year, BUT the volunteer hours can not start until
the end of the NLC and go until the deadline date each year.
J 33
National Service Project
The National Service Project is_______________.
For more information please contact the following address:
J 34
The Blue Cross and Blue Shield of
North Carolina Foundation
Breast Health Project
Program Goals:
This program seeks to reach as many women as possible across the state with
information on breast health, with the hopes of increasing knowledge about breast
health and mammography usage, particularly among women in the highest risk
category. While there have been lay health advisor programs that have proven
successful, this program will use the same model, but advisors would be high school
students in health occupations classes. We will examine the impact of intergenerational
lay health advisors. The main teaching tool for the students is a necklace with beads
that represent different sizes of lumps that would be found by mammograms and selfexams. It also provides practical experience for health occupations students.
Audiences:
The students are charged with working with two audiences:
1) Women in the age-risk category for breast cancer. Students participate in and
create events and programs that allow them to talk to women about early
detection—mammography, in particular. Since the risk for developing breast cancer
is much higher in older women, students’ outreach efforts should focus on older
women. A component could be added that would help students to instruct other
women how to teach about breast health and mammograms.
2) Other students. This is a secondary effort, since girls at high school age are
generally not at risk for breast cancer. The in-school focus would be on raising
awareness about breast cancer and teaching them to talk with women in their lives
about breast health and the importance of mammography screenings, clinical breast
exams and self-exams.
Kits:
Free kits were distributed to health occupation teachers across the state. Each school
received one kit for the health occupation teacher. Items included:
 3-4 sets of beads with a card attached that will have statistics and information on
how to use the beads.
 Brochure that corresponds with breast bead card and has more information on
breast health and mammography screenings. These brochures are used as a
handout at community events.
 Poster that corresponds with brochure and breast bead cards. Posters can be
hung in places the students may visit. For instance, if the students go to a senior
center or church event, they can leave a poster.
J 35



Hand-out of a “flow chart” of responses to encourage women to receive a
mammogram. Teachers can use this piece to discuss with students reasons why
women may object to receiving a mammogram.
Resource guide and curriculum guide that includes information on the program
and its goals, ideas for program activities and community service projects that
would enable the teens to reach women, assessment tools and a variety of other
resources.
Stickers to remind women to conduct their self-exams and to get mammograms.
Health occupation instructors teach students about breast cancer and early detection.
Additionally, instructors also teach students how to teach others about breast health and
mammography. This may require 4-5 class sessions.
The program is evaluated through pre-assessment and post-assessment tests for
students as well as some tools to measure the impact on women in the age-risk
category for breast cancer.
Teacher Involvement
Teachers signed agreements to implement the program. In signing the agreement,
teachers accepted the following responsibilities:
Attend a training session, at which they received the full kit
Teach the program for two years
Follow the curriculum which will be provided in the kit.
Report to the Blue Cross and Blue Shield of North Carolina Foundation on
student community activities and results.
Training sessions were held in different regions. In addition to the breast healthfocused training, sessions included information on public relations and grant writing.
They also counted toward credit for continuing education.
Teachers should encourage their students to enter their community projects in HOSA
competitions.
J 36
Breast Health Project Recognition Award
Deadline: February 14, 2011
NC-HOSA is proud of the partnership with Blue Cross and Blue Shield of NC
Foundation for the Breast Health Project. Local and regional HOSA support of this
project is greatly encouraged and supported. All NC-HOSA Chapters who participate in
this project will be recognized during the Opening Session of the State Leadership
Conference in March 2010. This form must be submitted to the address below in order
to receive recognition:
School__________________________________Region___________________
Total Chapter Membership______________________

Describe your activities which support the Breast Health Project (you may use a
separate sheet of paper if necessary). Include a copy of the Project contract which
has been signed by the advisor.

Total chapter hours of volunteer service
(Non-fundraising)
Hours per member of organizational service
(Total hours divided by chapter membership)

_____
_____
We verify that the information contained in this report is complete and accurate.
Organizational Representative ____________________________ Date _________
Student Submitting Report _______________________________ Date _________
Chapter Advisor _______________________________________ Date _________
This application must include a 1-2 page attachment with an outline of chapter
involvement in the Blue Cross Blue Shield of NC Breast Health Project – to include a
brief description of each activity, date, location, total hours, etc.
Mail completed form by February 14, 2011 to:
FAYE CRESS/NC HOSA
NCDPI - CTE
6358 MAIL SERVICE CENTER
J 37
RALEIGH NC 27699-6358
North Carolina HOSA
Gold Star Advisor
(Revised June 2005)
Purpose: To recognize advisors who encourage students’ participation and who
actively participate in HOSA activities.
Time Period: Points for the Gold Star Advisor are tallied from one HOSA State
Conference until the deadline for the next State Conference. Points are tallied from the
categories listed.
Directions: Circle the applicable score values. Provide documentation with the Gold
Star Advisor form as requested.
Service Projects: Other service projects include any project that provides a service to
others.
Responsibility: The chapter advisor or designee is responsible for completing the point
sheet and providing documentation as needed.
Recognition: Advisors who total 75 points or more will be recognized at the Advisor
Orientation during the NC HOSA State Conference.
Advisor of the Year: The advisor who scores the highest points will be announced as
the Advisor of the Year. This advisor will be recognized at the advisor orientation,
Opening Session and at the National HOSA Conference.
Documentation: Documentation must be presented in an organized manner and
properly labeled. Points may be deducted if materials are not presented in an orderly
manner.
Number: The number of advisors to be recognized may vary each year according to the
point system as set by the NC-HOSA Board of Directors.
Mail to: The Gold Star Advisor form and supporting documentation must be mailed
to:
Faye Cress, NC-HOSA
NCDPI - CTE
6358 Mail Service Center
Raleigh, NC 27699-6358
Deadline: February 14, 2011
J 38
Name __________________________________
District ___________
North Carolina HOSA
Gold Star Advisor
(Revised June 2010)
Directions: Circle the applicable score values. Provide documentation with the Gold Star
Advisor form as requested.
State Leadership Conference
Attended
State Officer Application(s)
State Officer Candidate(s)
Event Manager
Section Leader
Judge, timekeeper, HOSA Store, etc.
CE Director
CE Co-Director, CE Lieutenant
NC-HOSA Management Team
National Recognition Student(s) –
(Awarded 1 Per Student)
District Leadership Conference
5
2
5
5
3
2
10
8
4
_____
Attended*
District Management
Event Manager
Section Leader
Judge
Timekeeper, other assignments
Advisor District Officer(s)
Other Considerations
NC-HOSA Board of Directors
NC-HOSA Board Chair
100% Affiliation
HOSA 100
Advisor to State Officer
Advisor to National Officer
Host for Fall Leadership
Host for District Conference
National Leadership Conference
Attended
Event Manager
Section Leader
Judge
Timekeeper, dance, other assignments
5
7
5
5
3
10
5
5
5
4
2
5
5
Service Projects*
Local Chapter Membership
Membership per Advisor
(Need documentation of membership
per advisor)*
5 – 25 = 1
76 – 99 = 4
26 – 50 = 2 100 – 149 = 5
51 – 75 = 3 150+ = 6
____
Membership compared to last year
Stable = 1
Increase
5% = 1
20% = 5
10% = 3
25+ = 6
15% = 4
____
National HOSA Service Project
NC HOSA Service Project
NC HOSA – Breast Health Project
American Red Cross
Rex Blood Services
Other Blood Services ______________
Prevent Blindness
Other Service Projects (Max.2 projects)
10
10
5
5
5
5
5
5-10
Years of Service to HOSA
(Years as a local HOSA advisor)
1st year = 1
16-20 = 5
2-5 = 2
21-25 = 6
6-10 = 3
26+ = 7
11-15 = 4
Fall Leadership Workshop
Attended
District Officer Candidate(s) 0-3
Student Members attended*
1=1
5-7 = 3
2-4 = 2
8-10 = 4
5
8
5
3
3
2
1
5
___
___
___
Involvement with MRC Unit*
Total Points
5
_______
*Please provide documentation for appropriate areas for credit.
Mail to: Faye Cress, NC-HOSA, NCDPI – CTE, 6358 Mail Service Center, Raleigh, NC 27699-6358
Application must be Received By: February 14, 2011
J 39
North Carolina HOSA
Gold Star Chapter
(Revised June 2010)
Purpose: To recognize outstanding NC HOSA Chapters who encourage students’
participation, follow the HOSA plan of work, and actively participate in HOSA activities
to achieve their goals.
Time Period: Points for the Gold Star Chapter are tallied from one HOSA State
Conference until the deadline for the next State Conference. Points are tallied from the
categories listed.
Directions: Circle the applicable score values. Provide documentation with the Gold
Star Chapter form as requested. Use the “Other” areas to document scholarship
winners, Barbara James awards, etc.
Responsibility: The chapter president or designee is responsible for completing the
point sheet and providing documentation as needed.
Recognition: The top NC HOSA chapters from each membership category will be
recognized at the Opening/Recognition Session at the NC HOSA State Conference.
New Chapters: All new chapters will be placed into another category and the top
chapters from this category will be recognized at the Opening Session at the NC-HOSA
State conference.
Service Projects: Other Service Projects include any project that provides a service to
others.
National Leadership Conference “Other”: This includes chapters that are recognized
for at the National Conference for National HOSA Week, scholarships awarded
members, membership, etc.
Documentation: Documentation must be presented in an organized manner and
properly labeled. Points may be deducted if materials are not presented in an orderly
manner.
Number: The number of chapters to be recognized per membership category will be
determined each year.
Mail to: The Gold Star Chapter form and supporting documentation must be mailed to:
Faye Cress, NC-HOSA
6358 Mail Service Center
Raleigh, NC 27699-6358
Deadline: February 14, 2011
J 39
Chapter __________________________________ District ___________
North Carolina HOSA
Gold Star Chapter
(Revised June 2010)
State Leadership Conference
Other Considerations
Chapter Represented by Students
5
State Officer Application(s)
2
State Officer Candidate(s)
5
State Winners (Add only once)
1st Place
5
2nd Place
4
3rd Place
3
Top Ten
2
National Recognition Student(s)
(1 pt. per Recognized Student)
_____
Barbara James Service Award
(1 pt. per recognized student)
_____
Other: _______________________
1
_______________________
1
Scholarship awarded student
_____
(1 point per student)
100% Affiliation
HOSA 100
National Leadership Conference
District Leadership Conference*
5
5
Local Chapter Activities*
Chapter Flag
HOSA Week Activities (0 – 5)
(1 point per day of activities –
HOSA Public Awareness
Local Plan of Work
Communication with District Pres.
3
_____
3
5
3
Fall Leadership Workshop*
District Officer Candidate(s)
(1 point per candidate. 0 - 3)
Student Members attended*
1=1
5-7 = 3
2-4 = 2
8-10 = 4
Chapter Represented by Students
5
National Winners (Add only once)
1st Place
6
2nd Place
5
3rd Place
4
Top Ten
3
President Service Award
(1 pt. per recognized student)
_____
Other: _______________________
1
_______________________
1
Scholarship awarded student
_____
(1 point per student)
_____
_____
Chapter Represented by Students
District Winners (Add only once)
1st Place
2nd Place
3rd Place
Top Ten
5
4
3
2
1
Service Projects*
Local Chapter Membership
Membership*
______
5 – 25 = 1
76 – 100 = 4
26 – 50 = 2
100+ = 5
51 – 75 = 3
Membership compared to last year ______
Stable = 1
Increase 5% = 2
20% = 5
10% = 3
25% = 6
15% = 4
Alumni Members (1 pt. each, Max. 5) _____
Professional Members
(1 pt. each, Max. 5)
_____
NC HOSA Service Project
National HOSA Service Project
Breast Health Project
American Red Cross
Rex Blood Services
Other Blood Services _________
Prevent Blindness
Other Service Projects (Max.2)
10
10
5
5
5
5
5
5-10
MRC Partnership*
Work with an active MRC
(1 point per project up to 5 max.)
____
Teen CERT
5
Local HOSA Web site
5
TOTAL POINTS
______
*Remember to provide documentation as needed.
Mail to: Faye Cress, NC-HOSA, 6358 Mail Service Center, Raleigh, NC 27699-6358
Deadline: February 14, 2011
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