Clements High School Leadership Class Application 2016 – 2017
Thank you for your interest in becoming a part of Clements High School’s Leadership Class.
Leadership is one of the essential components of this school, and its responsibilities range from
organizing dances, rallies, spirit days, and community service projects, to representing the students of
Clements at large and ensuring that decisions made by the staff or the administration are in their best
interests. The Leadership class requires a person who is responsible, resourceful, and perhaps most
important, self-motivated.
This is a weighted elective course that provides opportunities to study, practice and develop group
and individual leadership and organizational skills. These skills include decision-making skills, problemsolving techniques, communication skills, leadership roles, human relation skills and understanding the
need for civic responsibility. Students enrolled in the course will apply these skills in dealing with peers,
school administration and the community.
The following application is one way we determine which applicants would be best suited for this
course. The information on this application – in particular your answers to the questions on the
following pages – will be combined with your grade point average, your school attendance and
discipline record, and completed sponsor/teacher recommendations to rank you with all other
applicants for strong leadership potential. The top applicants will be accepted into Leadership,
space permitting. Applicants for the course should be an officer/leader of his or her respective
organization for the 2016-2017 school year. This application is due on Friday March 11th, 2016 to room
1118.
A teacher recommendation and a coach/sponsor recommendation are required for applications to
be taken in consideration. Provide the recommendation form to a former or current teacher as well
as your current sponsor/coach. They will need to turn in the form to Ms. Nguyen’s mailbox in the
teachers’ mail room.
Upon acceptance, visit your counselor to see how this will count towards your graduation plan.
By signing below, I indicate that I have read and agree to the stipulations above.
Student’s Signature
Parent/Guardian’s Signature
Full Name
Current Grade
Extracurricular Activities
Officer position(s) for the 2016-207
year
*Clubs, organizations, honor societies,
sports
Date
Date
Short Answer Questions
Please answer these questions so that we might get a better impression of you. Please write neatly.
You may also type the answers if you would like, and attach the answers. Please do not handwrite
your answers on a separate sheet of paper. Just be yourself!
1. Why would you like to take the Leadership course? What would you like to take away from the
course at the end of the year?
2. In Leadership, there will be times when you will have to work with others, and times when you will
work independently. Which do you prefer, why?
3. List and describe the two most important activities that you are involved in at Clements as well as
your role within those activities (can include: sports, dance, drama/drama production, music, clubs,
organizations, honor societies, etc.)
4. Interpret the quote, “Attitude reflects leadership.”
APPLICATION DUE BY FRIDAY MARCH 11TH, 2016 TO MS. NGUYEN (ROOM 1118)
Students: Fill in
name and ID #
and give form to
your reference
Student Leadership Teacher Recommendation Form
CONFIDENTIAL SPONSOR/COACH RECOMMENDATION FORM
This is a weighted elective course that provides opportunities to study, practice and develop group
and individual leadership and organizational skills. These skills include decision-making skills, problemsolving techniques, communication skills, leadership roles, human relation skills and understanding the
need for civic responsibility. Students enrolled in the course will apply these skills in dealing with peers,
school administration and the community.
The following recommendation form is a completion component of the application that will help us
identify potential leadership abilities in the application. Students in the course must be a current
officer/leader/captain of their respective organization. The top applicants will be accepted into
Leadership, space permitting. Please turn in student recommendation forms to Ms. Nguyen’s mail
box (or room 1118).
Student’s Name _________________________________ Student ID # _____________
Please check in the appropriate column the factors for which you have adequate
information for appraisal.
GOOD
1.
Ability to follow instructions
2.
Social skills (gets along well/respect for others)
3.
Demonstrates dependability
4.
Self-motivated
5. Demonstrates responsibility (directs energies
toward tasks
6. Demonstrates enthusiasm in performing
assigned tasks
7.
Strives for excellence
8.
Punctual
9. Mentally alert (organization skills/problemsolving skills)
10. Demonstrates proper etiquette and manners
11. Personal appearance/grooming
12. Demonstrates integrity/honesty
13. Demonstrates optimism and self-respect
FAIR
POOR
Cannot
determine
GOOD
FAIR
POOR
Cannot
determine
14. Capacity to try new ideas and increase
knowledge
15. Attitude toward constructive criticism
16. Ability to adapt to change
17. Cooperates with others
18. Communication skills
19. Demonstrates attention to detail
20. Ability to set realistic goals
21.
Do you recommend this applicant for the Student Leadership course?
□ Yes
□ No
22. Is the applicant an officer/leader/captain in your club/organization/sport for the 2016-2017 school
year?
□ Yes
□ No
23. Supplementary Comments
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_____________________________________________
Signature
_____________________________________________
Print Name
___________________________
Date
___________________________
Subject Area
FORMS DUE TO MS. NGUYEN BY FRIDAY MARCH 11, 2016. Can
be delivered to 1118 or submitted through mailbox!
Students: Fill in
name and ID #
and give form to
your reference
Student Leadership Teacher Recommendation Form
CONFIDENTIAL TEACHER RECOMMENDATION FORM
This is a weighted elective course that provides opportunities to study, practice and develop group
and individual leadership and organizational skills. These skills include decision-making skills, problemsolving techniques, communication skills, leadership roles, human relation skills and understanding the
need for civic responsibility. Students enrolled in the course will apply these skills in dealing with peers,
school administration and the community.
The following recommendation form is a completion component of the application that will help us
identify potential leadership abilities in the application. The top applicants will be accepted into
Leadership, space permitting. Please turn in student recommendation forms to Ms. Nguyen’s mail
box (or room 1118).
Student’s Name _________________________________ Student ID # _____________
Please check in the appropriate column the factors for which you have adequate
information for appraisal.
GOOD
1.
Ability to follow instructions
2.
Social skills (gets along well/respect for others)
3.
Demonstrates dependability
4.
Self-motivated
5. Demonstrates responsibility (directs energies
toward tasks
6. Demonstrates enthusiasm in performing
assigned tasks
7.
Strives for excellence
8.
Punctual
9. Mentally alert (organization skills/problemsolving skills)
10. Demonstrates proper etiquette and manners
11. Personal appearance/grooming
12. Demonstrates integrity/honesty
13. Demonstrates optimism and self-respect
FAIR
POOR
Cannot
determine
GOOD
FAIR
POOR
Cannot
determine
14. Capacity to try new ideas and increase
knowledge
15. Attitude toward constructive criticism
16. Ability to adapt to change
17. Cooperates with others
18. Communication skills
19. Demonstrates attention to detail
20. Ability to set realistic goals
24.
Do you recommend this applicant for the Student Leadership course?
□ Yes
□ No
25. Supplementary Comments
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_____________________________________________
Signature
_____________________________________________
Print Name
___________________________
Date
___________________________
Subject Area
FORMS DUE TO MS. NGUYEN BY FRIDAY MARCH 11, 2016. Can
be delivered to 1118 or submitted through mailbox!