ARROWHEAD HIGH SCHOOL
NATIONAL HONOR SOCIETY INFORMATION APPLICATION FORM
NHS Applicants: Please read the directions below to complete the form correctly. Applications must be turned in
by the deadline or will not be accepted. On the front side, do not list an activity in more than one table.
Disclaimer: Applicants who incorrectly fill out form, have parents fill out form, or provide false information will not be considered.
Full Name: ______________________________________
Current Grade (circle one):
SCHOLARSHIP: Members must maintain at least a 3.5 cumulative GPA.
Sophomore
Junior
Senior
Cumulative GPA: ______________
List GPA as of Feb. 1st 2016. Round to the thousandth.
ACTIVITIES (SCHOOL/COMMUNITY): In the tables, list non-service activities participated in during high school
(no middle school activities). For each activity: identify the activity and role (captain, participant, etc); list the grades during
which you participated (9, 10, 11…); describe the duration (1 week, fall, all year) and frequency (once, 5 days/wk,
all summer); the total hours spent in this activity. Not all rows need to be filled in. Do not use essay format.
A. School Activities: Include involvement/membership in school related, non-service, non-classroom related activities
completed outside of the school day. Consider including: academic teams or groups (academic decathlon, math
team), athletics, extracurricular and intramurals, Student Senate, Key Club, Broadway Company, cheerleading, etc.
Activity and Role
Grade(s)
Duration
Frequency
Total Hours
B. Community Activities: Include all non-school related, non-service related activities, such as: Boy/Girl Scouts, club
athletics, a member of a youth orchestra, ballet classes/recitals, babysitting, etc. Employment can be included here.
Activity and Role
Revised 01/2016
Grade(s)
Duration
Frequency
Total Hours
SERVICE: In the table, list all non-paid service activities in which you’ve participated in. Include the organization and/or
event (Salvation Army, SASS tutoring, Habitat for Humanity, mission trip, etc); include role (volunteer, server, snow shovel,
math tutor, etc.); include grades of participation; and include duration, frequency, and total hours.
Organization/Event
Role
Grade(s)
Duration
Frequency
Total Hours
LEADERSHIP: In the table provided, please list all leadership positions in school and community that you’ve held during high
school years. Please include a brief description of your leadership role in that activity (Do not use essay format).
A. Leadership Positions: List leadership positions such as: captain (school or club), committee chairperson, lead role
in a play, band/orchestra/choir leader, created or organized a volunteer opportunity at church or organization.
List the Activity or
Organization
State Your
Leadership Role
How does your role in this activity demonstrate
leadership?
Grade(s)
Total
Hours
B. Leadership Recognitions: List recognitions you’ve received such as: Badger Boy or Girl, AFS overseas selection,
All-Conference in a sport (school or club), “A” Rating in State Forensics, “1” Rating in Solo Ensemble, etc. Briefly
explain why you were recognized. Do NOT list academic recognitions related to GPA (honor roll). You can attach
documents (newspaper article, brochure, etc.) to your application to better explain your leadership recognition(s).
Leadership Recognition you Received
Grade(s
)
Briefly described why you were recognized for this award and
how it demonstrates leadership.
CHARACTER: Have you ever cheated, plagiarized, or violated Arrowhead Union High School’s rules of conduct (page
29 of Student Handbook)?
CHECK: Yes ▢
No ▢
If yes, please explain briefly: ____________________________________________________________________________
___________________________________________________________________________________________________.
Revised 01/2016
PLEASE NOTE: If the NHS Faculty Council selects you for NHS membership, you will be required to sign the NHS Honor Code
at the mandatory induction night in April. The code states: As a member of NHS, I understand I am an example to others. I will only
present my academic work and will not attempt to gain or provide an unfair advantage over students through cheating or plagiarism. It
is expected all members attend all NHS meetings, complete the service hour requirement, and continue to succeed academically.
STUDENT REVIEW: By signing below, you verify the information provided above is complete, honest and accurate. I
understand that once applications have been submitted, I cannot add additional activities to this application.
________________________________________ (Student signature)
___________________ (Date)
PARENT REVIEW: I reviewed my son’s/daughter’s application and affirm it is correct and complete. I give my son/daughter
consent to apply for membership into Arrowhead’s Chapter of National Honor Society and verify I did not fill out this application. I
understand that if this application has been filled out by a parent, my son/daughter will be not be eligible for NHS membership.
________________________________________ (Parent/Guardian signature)
Revised 01/2016
___________________ (Date)