Portfolio for National Honor Society
Briar Woods High School
Congratulations! Based on your academic grade point average you are invited
to apply for membership in the Briar Woods Chapter of the National Honor
Society. A faculty selection committee will soon be reviewing all eleventh and
twelfth grade students who are academically eligible for membership and have submitted portfolios.
Membership in the National Honor Society is based upon excellence in four areas: scholarship,
leadership, service and character. Each category is judged independently.
To be eligible for membership, students must have at least a junior standing, and a weighted
cumulative GPA of at least a 3.5. In addition to the academic requirement, there are standards in leadership,
service, and character, which are required. Leadership requirements include a demonstration of leadership in
school as well as outside of school. Service requirements include involvement in service projects since the
start of the high school career. Character requirements include integrity, positive behavior, ethics,
cooperation, and reliability in and out of school and classroom maturity.
After students become members of the National Honor Society, they are reviewed periodically by
the advisers and must maintain the high standards of the Society. Active members in the National Honor
Society are required to maintain a cumulative 3.5 GPA or better and live up to the character, leadership, and
service ideals of the National Honor Society.
Students who are invited to apply to the National Honor Society membership are under no obligation
to complete the candidate portfolio. Although you are to be commended for maintaining a high scholastic
average, please understand that membership is not guaranteed to anyone. The faculty committee makes the
final decision for membership. The NHS Advisers are nonvoting members. If you have any questions regarding
the Society, the selection procedures or membership, please contact Mr. Mosser or Mr. Sarmento at any time.
PLEASE NOTE:
•
Complete ALL sections of the information form. Please type or print with black ink. Do not be
modest. The application is the major component of the selection process. Be clear and detailed in your
responses.
•
Please prioritize your activities, listing those to which you had the greatest commitment first.
Avoid repeating your involvement in organizations/activities in more than one section of the application
form.
•
This information form requests the name of an adult sponsor who can verify your involvement in
the activities listed. You MUST include the adult sponsor’s name and contact information (e-mail or phone
number) and signature. Hours documented on letterhead will be accepted in lieu of signature.
•
Completed applications are due to Mr. Mosser in Room 505 by 4 p.m. on Monday, October 12.
•
Details of the induction ceremony will be discussed after the Selection Committee reaches it decision.
•
Before further consideration, it is necessary for you and your parent or guardian to sign this form (a
waiver to any right to access information, evaluations, recommendations, judgments, or whatsoever in the
selection process). Further consideration will not be made until this waiver is signed and returned.
Student Signature/Date
Parent Signature/Date
PART 1
ADMINISTRATIVE INFORMATION
Full Name
Grade_
Home Address
E-mail
PART 2
Phone Number
EXTRA-CURRICULAR ACTIVITIES
I. School Activities -- List all activities in which you have participated during high school. Include clubs, teams,
musical groups, etc., and major accomplishments in each. Include activities you know you will participate in
during this school year. For example, if you know you will participate in track, but the season hasn't begun,
please include it. List the name of the adult supervisor who can verify your participation in each activity.
Verifying signatures and phone numbers are required.
School Activities
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10
11 12
Accomplishments
2
Sponsor
Name and
Phone No.
Sponsor’s Signature
PART 3
LEADERSHIP POSITIONS
Leadership will be divided into two areas, elected positions, and student leadership. List all elected or
appointed positions held in which you have been an active member in high school. Include clubs, musical
groups, committees etc., and major accomplishments in each. Major accomplishments include, but are not
limited to, club officer, president, vice president, secretary, treasurer, and awards. Please list athletics on the
table found on the following page only. Verifying signatures and phone numbers are required.
Section A: Elected & Appointed Positions- List all elected or appointed positions held in school. Only the
positions in which you were directly responsible for directing or motivating others should be included. For
example, elected to student council, club officer, committee chairperson, newspaper editor, work manager,
church youth group officer, 4‐H officer, etc.
Leadership Position
9
10
11
Accomplishments/Leadership
Positions
3
Sponsor
Name and
Phone No.
Sponsor’s Signature
Please sign only if
this individual is an
active member
Athletics example: Sports team captain or co‐captain, etc. VL=Varsity Letter
Athletics:
Completed Season
9
10
11 12
Accomplishments
Coach Name
and Phone
No.
Coach’s Signature
Section B: Student Leader & Leadership Examples: Many students are leaders in various ways without ever
being elected to a leadership position. In this section we want you to describe how you are a leader in your
classroom, school, and /or community. Student leaders are resourceful, good problem solvers, idea
contributors, dependable, and have a positive attitude about life. Below list a leadership quality that you
possess and then give an example of a time when you demonstrated this leadership quality. Use as many of
the spaces below that you desire, you do not have to use each space, but the more information you can
provide the better.
Leadership Quality
Example that Demonstrates this Quality
I often lead classroom discussion in my English class.
Examples:
Leader
I always arrive to my job at Dairy Queen on time, and
pick up shifts for others.
Dependable
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PART 4
SERVICE ACTIVITIES
List all the community service activities you have participated in that have benefited the school and/or the
community. Generally speaking, service activities are those which are done for or on behalf of others (not
including immediate family members) for which NO compensation (monetary or other) have been given. For
example, church groups, Boys or Girl Scouts, Habitat for Humanity, Special Olympics. Additionally, if the
service activity was a requirement of your membership in an extra-curricular activity, you should NOT include
it. (For example, the cross country team, in the past, has cleaned up the stadium after home football games.
This was a requirement of its members, therefore would not count toward service hours.)
If you participated in any service activity within the school, list and describe that as well, along with the
number of hours you performed the service. List the name of the adult supervisor who can verify your
participation in each activity. Please try to have the signature be from an adult other than a parent, unless
your parent was directly responsible for that activity. Verifying signatures and phone numbers are required.
Community
Activity
9 10
11 12 Explanation of
Activity
Sponsor
Name
and
Phone
No.
If the above section is left blank, please explain why.
5
Start &
End Date
Sponsor’s
Signature
Total
Hours
Completed
Are You
Still
Doing
This?
WORK EXPERIENCE
PART 5
List below any job/work experiences you have had during high school that support your bid to be selected for
membership in National Honor Society. Work experience may be paid or volunteer. Work experience may
include some of the following types of activities: babysitting, farm work, lawn work, employment at a
local place of business, etc. Name of Sponsor and phone numbers are required for work experience.
Signatures are not required.
Job
Experience
9 10 11 12
PART 6
Duties at Work
Sponsor
Name
and
Phone
No.
Start and
End Date
Hours
Completed
Are
You
Still
Doing
This?
HONORS AND RECOGNITIONS
Please list any awards or recognitions, not already mentioned on this form, which you have received during
high school. Examples: Student‐of‐the‐Month, Sportsmanship Award, local art award, etc.
A. Recognition- Formal acknowledgement of an achievement, i.e. special notice or attention.
Recognitions
9 10 11 12
Group or Activity
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B. Awards An item that is given to you as an acknowledgement of an achievement, i.e. trophy, certificate
(usually a physical item.) Boy Scouts‐Life, Eagle, etc., Girl Scouts‐ Bronze, Silver, Gold Awards.
9 10 11 12
Group or Activity
Award
PART 7
ESSAY
Perhaps the most difficult area to evaluate for selection of members is that of character. To assist the faculty
advisory committee in their decision, we are asking you to write a brief essay describing how you display
character and how you plan to consciously improve in this area by the time you graduate from Briar Woods
High School. Please attach a one‐page, double‐spaced, computer generated essay expounding upon this topic.
Spelling, grammar and neatness, along with quality of response will be part of the evaluation process. Do not
forget to use a spell checker and have someone proofread your paper for mistakes, etc. Responses should be
a minimum of 250 words with a maximum of 500 words.
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Recommendation Letter for National Honor Society
Briar Woods High School
Directions to Student: Identify someone in the community and school who can attest to the SERVICE and/or
LEADERSHIP that you have provided over the past two years and/or longer. Provide him/her with an envelope
addressed to Mr. Mosser and have him/her sign the sealed envelope and return it with your application. You
must include two (2) recommendation letters - one from a community member or coach and one from a
teacher that you have had at Briar Woods.
Directions to Writer: Briar Woods High School is in the process of selecting National Honor Society
members. We would like your feedback as to the SERVICE and/or LEADERSHIP this applicant has
demonstrated. Please comment on:

The applicant’s commitment to service

The nature of the activities

How this person demonstrated leadership in events or organizations

Additional comments about the CHARACTER (honesty, reliability, etc.)of the applicant
Please seal the envelope, sign over the seal, and mail it to Mr. Josh Mosser at 22525 Belmont Ridge Rd,
Ashburn, VA 20148 or return it to the applicant. Please reference the student on the front of the envelope.
Letters must be submitted by the application deadline. No Exceptions. Please talk to the NHS Candidate
for the Due Date.
Student Name:
Writer's Name:
Signature of Writer:
Date:
Position:
Phone Number:
How long have you known the applicant?
Please attach a separate letter to this page to comment on this individual's service and/or leadership to your
organization. Please do not use the back of this page.
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Recommendation Letter for National Honor Society
Briar Woods High School
Directions to Student: Identify someone in the community and school who can attest to the SERVICE and/or
LEADERSHIP that you have provided over the past two years and/or longer. Provide him/her with an envelope
addressed to Mr. Mosser and have him/her sign the sealed envelope and return it with your application. You
must include two (2) recommendation letters - one from a community member or coach and one from a
teacher that you have had at Briar Woods.
Directions to Writer: Briar Woods High School is in the process of selecting National Honor Society
members. We would like your feedback as to the SERVICE and/or LEADERSHIP this applicant has
demonstrated. Please comment on:

The applicant’s commitment to service

The nature of the activities

How this person demonstrated leadership in events or organizations

Additional comments about the CHARACTER (honesty, reliability, etc.)of the applicant
Please seal the envelope, sign over the seal, and mail it to Mr. Josh Mosser at 22525 Belmont Ridge Rd,
Ashburn, VA 20148 or return it to the applicant. Please reference the student on the front of the envelope.
Letters must be submitted by the application deadline. No Exceptions. Please talk to the NHS Candidate
for the Due Date.
Student Name:
Writer's Name:
Signature of Writer:
Date:
Position:
Phone Number:
How long have you known the applicant?
Please attach a separate letter to this page to comment on this individual's service and/or leadership to your
organization. Please do not use the back of this page.
9
Checklist for National Honor Society
Briar Woods High School
Checklist (please complete and submit WITH your final application) Remember that your
application will not be considered if you are missing any of the following from the checklist
below.
Did you remember to. . .

Type or write the application neatly and in black ink? Did you proof your
application?

Did you edit (Ask a teacher to review essay for you!) and type your essays?

Paper clip rather than staple the application together? Sealed in a large envelope
with your name on the envelope?

Make sure no items were taped or glued to the application?

Make sure you have ALL necessary signatures and phone numbers?

Place your letters of recommendation in a signature-sealed envelope?
DUE DATE:
Tuesday, October 13, 2015 by 4 p.m.
Parent/Guardian and Student Consent
We have reviewed this application and the attached cover letter. We are aware of the
requirements for application and recognize that failure to comply with these standards may
disqualify this application. We understand the election criteria (Student Information Sheet,
Attendance Record, Discipline Record, and Recommendation Letters). We also understand that
students selected for the National Honor Society must attend meetings and functions as
required. If accepted into NHS membership you are expected to participate in all activities
including the fund raiser to help cover the costs of service projects, end of the year awards, patches, annual
awards breakfast, etc. There is also membership dues explained at the first meeting. If you sign up to go on a
field trip and then cancel out, you will be expected to reimburse NHS for your individual costs. THERE ARE NO
EXCEPTIONS TO THIS RULE! We recognize that students will be required to perform a minimum of 30 hours of
community service hours (outside of Briar Woods HS), maintain a 3.5 GPA, and may be removed from the
Society for failing to meet these requirements.
Student Name
Student Signature
Parent Name
Parent Signature
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