Name: _____________________________________ Student ID #: ________________ Gender: M
F
E-mail Address: _________________________ Phone Number: _________________________
English Teacher/Class Period: ______________ Current Grade Level (circle one):
10
11
William G. Enloe National Honor Society
Survey for Potential Members
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. NHS members attend monthly meetings, complete five service
projects each year, participate in an Enloe teacher assisting project, and maintain a high level of moral character.
Member requirements are as follows:
· You may miss only one meeting (including the annual induction ceremony) during the year.
· You must complete FOUR service projects per year.
· You must complete FIVE Teacher Assisting hours per QUARTER.
· You must maintain a 3.5 (unweighted) GPA.
· You must maintain good moral character.
To be considered for membership in the W. G. Enloe Chapter of the National Honor Society, a student must be a rising
junior (second semester sophomore), or a rising senior (second semester junior), with a minimum cumulative grade point average of
3.5 (unweighted). The Faculty Council will select from all academically qualified applicants those students who excel in scholarship,
leadership, service, and character. The Faculty Council consists of five members of the Enloe faculty, appointed by the principal,
and includes the National Honor Society adviser as a non-voting member. Information from this student survey, and input from
the entire faculty and administration, will be considered.
Note: Selection to the National Honor Society is an honor akin to receiving an award for demonstration of scholarship,
leadership, service, and character. According to page 35 of the National Honor Society Handbook, “Parents and
students must understand that no student has a right to be selected for membership in a chapter of the National Honor
Society.” However, no quota exists; each student who, in the judgment of the Faculty Council, meets the criteria for
membership will be selected.
Please read the following and sign below:
I have read the above information concerning National Honor Society and the process of member selection. I am aware that the
selection process is in accordance with national guidelines. I understand that any problems with non-selection may be referred to
the principal, who will intervene only if a technical error such as inadvertent omission of a student’s name or incorrect GPA has
been made. I further understand that a GPA of 3.6 is a cutoff point, but that a higher GPA does not necessarily increase a
candidate’s chances for acceptance. I understand that completing this student survey does not guarantee my selection to the W. G.
Enloe Chapter of the National Honor Society.
I would like the five-member Faculty Council to consider my candidacy for National Honor Society. If selected, I am willing to
continue my commitment to the high standards of scholarship, leadership, service, and character required by NHS. I also agree to
meet the membership requirements as outlined above. I understand that failure to maintain these standards can result in loss of
membership privileges, which cannot be reinstated.
Please Note: A completed survey consists of service and leadership verifications, a character statement, and all required
signatures and dates. Failure to include any of these elements may result in the survey not being considered by the
faculty committee.
I certify that all information I have provided in this survey is original, factually correct and honestly presented to the best of my
knowledge.
Student signature: _____________________________________________
Date: ___________
My signature below indicates that I have read all of the procedures for admission to the W. G. Enloe Chapter of the National
Honor Society and understand that my student’s academic eligibility and completion of this survey do not guarantee selection to the
National Honor Society.
Parent/Guardian signature: ____________________________________________
Date: ___________
I.
Scholarship
A. Requirement: 3.5 minimum (unweighted, cumulative) GPA
B. In addition, please provide your schedule for the current school year, including the name of the course
and teacher.
1.
2.
3.
4.
5.
6.
a)
b)
7.
II.
Service
A. Requirement and Verification: Two different examples of community/school service that involve or
have involved a continuing commitment for a substantial period of time during high school, at least 25 hours
per example. You are expected to submit two “Verification Statement for Service” forms, completed and
signed by an adult who supervised your activities. Please note that you should submit one Verification
Statement form for each service activity or project that you discuss in Part A of Section II. (Note: Parent
and/or relative signatures on Verification forms are discouraged.) If circumstances prevent you from obtaining
a signature, please see an adviser. Each Verification form should include a paragraph detailing your role in the
activity described.
III.
Leadership
A. Requirement and Verification: Two different examples of community/school leadership that involve or
have involved a continuing commitment for a substantial period of time, at least 25 hours per example,
during high school. You are expected to submit two “Verification Statement for Leadership” forms,
completed and signed by an adult who supervised your activities. Please note that you should submit one
Verification Statement form for each leadership activity that you discuss in Part A of Section III. (Note:
Parent and/or relative signatures on Verification forms are discouraged.) If circumstances prevent you from
obtaining a signature, please see an adviser. Each Verification form should include a paragraph detailing your
role(s) and responsibilities in the activity described.
IV.
Character/Integrity
A. Criteria: According to page 29 of the National Honor Society Handbook, the 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, halls, 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 to rules, avoiding cheating in written work, and
showing unwillingness to profit by the mistakes of others
Actively helps rid the school of bad influences or environment
B. Requirement: Please submit a paragraph below with character information which should be
considered by the Faculty Council. Please include any examples or anecdotes which you feel
exemplify your character and integrity; specific information is more helpful than broad, general
statements.
C. A list of academically eligible students will be submitted to the entire faculty for their input in the selection
process. All information provided will be reviewed by the five-member Faculty Council and will remain
confidential.
V.
Essay: In at least a half a page, to no more than one full page, describe how you demonstrate the four
pillars (scholarship, service, leadership, and character) of National Honor Society.
Verification Statement for Service
I, _______, do affirm and avow that _________________________________________(student’s name)
did complete the following service project on the date(s) listed below.
Project title: ______________________________
Date(s) of Project: ____________
Approximate total number of hours spent: ______
Specific volunteer work you performed: _________________________
Please note that this student is submitting a survey for potential membership in the W. G. Enloe Chapter of the
National Honor Society. Any additional information you may wish to provide would give the Faculty Council further
insight into the character of the student. These comments are entirely optional, and lack of additional comments will
have no negative effects on this student’s survey.
If you wish to provide any additional comments, please write on the reverse side of this form and return this
form to the student in a sealed envelope with the student’s name on the front of the envelope and your signature across
the seal of the envelope.
TO BE COMPLETED BY THE STUDENT--Requirement: Submit a paragraph detailing your role(s) and
responsibilities in the aforementioned activity. You may type/write the information in the space provided.
To the supervisor: By signing this document, you are agreeing that the activity described above fits
the definition of “service”: unpaid, consistent and substantial involvement totaling at least 25 hours.
Name of Coordinator/Supervisor (please print clearly) _________________________________________
Signature of Coordinator/Supervisor: ___________________________________ Date: _____________
Supervisor’s phone number: ________________ Supervisor’s email: ___________________________________
Supervisor’s contact address:_____________________________________________________________________
Verification Statement for Service
I, _______, do affirm and avow that _________________________________________(student’s name)
did complete the following service project on the date(s) listed below.
Project title: ______________________________
Date(s) of Project: ____________
Approximate total number of hours spent: ______
Specific volunteer work you performed: _________________________
Please note that this student is submitting a survey for potential membership in the W. G. Enloe Chapter of the
National Honor Society. Any additional information you may wish to provide would give the Faculty Council further
insight into the character of the student. These comments are entirely optional, and lack of additional comments will
have no negative effects on this student’s survey.
If you wish to provide any additional comments, please write on the reverse side of this form and return this
form to the student in a sealed envelope with the student’s name on the front of the envelope and your signature across
the seal of the envelope.
TO BE COMPLETED BY THE STUDENT--Requirement: Submit a paragraph detailing your role(s) and
responsibilities in the aforementioned activity. You may type/write the information in the space provided.
To the supervisor: By signing this document, you are agreeing that the activity described above fits
the definition of “service”: unpaid, consistent and substantial involvement totaling at least 25 hours.
Name of Coordinator/Supervisor (please print clearly) _________________________________________
Signature of Coordinator/Supervisor: ___________________________________ Date: _____________
Supervisor’s phone number: ________________ Supervisor’s email: ___________________________________
Supervisor’s contact address:_____________________________________________________________________
Verification Statement for Leadership
I, _________________________, do affirm and avow that _________________________ (student’s name)
did participate in the following activity, demonstrating leadership in his/her school or community, on the
date(s) listed below.
Project title: ______________________________________________
Date(s) of Project: _________________________________________
Approximate total time spent: ____________________________________
Specific leadership activity: _________________________________________________________ _
Please note that this student is submitting a survey for potential membership in the W. G. Enloe Chapter of the
National Honor Society. Any additional information you may wish to provide would give the Faculty Council further
insight into the character of the student. These comments are entirely optional, and lack of additional comments will
have no negative effects on this student’s survey.
If you wish to provide any additional comments, please write on the reverse side of this form and return this
form to the student in a sealed envelope with the student’s name on the front of the enveloped and your signature
across the seal of the envelope.
TO BE COMPLETED BY THE STUDENT--Requirement: Submit a paragraph detailing your role(s) and
responsibilities in the aforementioned activity. You may type/write the information in the space provided.
To the supervisor: By signing this document, you are agreeing that the activity described above fits
the definition of “leadership”: consistent and substantial involvement totaling at least 25 hours
(leadership also includes representing Enloe High School to the public).
Name of Coordinator/Supervisor (please print clearly) _________________________________________
Signature of Coordinator/Supervisor: ___________________________________ Date: _____________
Supervisor’s phone number: ________________ Supervisor’s email: ____________________ _______________
Supervisor’s contact address:_____________________________________________________________________
Verification Statement for Leadership
I, _________________________, do affirm and avow that _________________________ (student’s name)
did participate in the following activity, demonstrating leadership in his/her school or community, on the
date(s) listed below.
Project title: ______________________________________________
Date(s) of Project: _________________________________________
Approximate total time spent: ____________________________________
Specific leadership activity: _________________________________________________________ _
Please note that this student is submitting a survey for potential membership in the W. G. Enloe Chapter of the
National Honor Society. Any additional information you may wish to provide would give the Faculty Council further
insight into the character of the student. These comments are entirely optional, and lack of additional comments will
have no negative effects on this student’s survey.
If you wish to provide any additional comments, please write on the reverse side of this form and return this
form to the student in a sealed envelope with the student’s name on the front of the enveloped and your signature
across the seal of the envelope.
TO BE COMPLETED BY THE STUDENT--Requirement: Submit a paragraph detailing your role(s) and
responsibilities in the aforementioned activity. You may type/write the information in the space provided.
To the supervisor: By signing this document, you are agreeing that the activity described above fits
the definition of “leadership”: consistent and substantial involvement totaling at least 25 hours
(leadership also includes representing Enloe High School to the public).
Name of Coordinator/Supervisor (please print clearly) _________________________________________
Signature of Coordinator/Supervisor: ___________________________________ Date: _____________
Supervisor’s phone number: ________________ Supervisor’s email: ____________________ _______________
Supervisor’s contact address:_____________________________________________________________________
“What activities should I include on my student survey?”
The following suggestions are not designed to “guarantee” selection for National Honor Society. Rather, they are
intended to serve as guidelines as to what general kinds of activities are appropriate for the categories listed on the
survey. They also give some insight into what is meant by “extended” or “substantial” time commitment. Again, these
are suggestions ONLY. There is no “magic formula” or guarantee for NHS selection.
Service
-At least 25 hours of service for each verification form
-No activity for which you received any form of material compensation (monetary, etc.)
-Consistent and substantial involvement: at least one semester, weekly, bi-weekly, or—in some cases—monthly
involvement. Time spent should include planning/organization time you may have spent for the project (i.e. planning
and organizing for a blood drive). One-time projects may not “stand alone,” but may be included as part of a larger
commitment (i.e. listing “Key Club” as one activity rather than “Interfaith Food Shuttle” and “Campus Clean-up”—
both done once as part of Key Club—for two activities).
-Some students have done short-term, service-oriented mission trips that last for approximately one week during the
summer. This does not represent a “consistent” involvement unless you have participated in such projects for at least
two summers beginning with the summer before your 9th grade year.
-Include only projects/activities that are entirely distinct and separate from activities listed under the “Leadership”
section of your survey. (i.e. If you are president of a youth group that does service projects, you should use that
activity for either service or leadership—not both.)
-In your description of each service example, include planning stages and any work involved before the project, details
about the actual project, and any work that was involved following the activity.
Leadership
-At least 25 hours for each verification form
-Consistent and substantial involvement for an extended period of time: at least one semester. Time spent should
include planning/organization time you may have spent before the project/activity.
-School related leadership should be school wide. Things such as being the leader of a class project or activity are not
appropriate. Appropriate activities include leadership in such organizations as student council, clubs or organizations
that are available to the entire student body, etc.
-Many students in the past have listed babysitting as an example of leadership. This is not an appropriate example for
NHS. Demonstrate leadership among your peers.
-Examples of leadership should be official positions whether at school, in the community, or in the workplace. For
example, holding a position as a manager at your after school job is appropriate; simply holding a job is not. Likewise,
being a team captain for a CASL soccer team is appropriate; simply playing in the league is not. At school, leadership
may also take the form of serving as an official representative of the school (i.e. marching band, football, academic
decathlon, or a club officer who has fulfilled significant, documented duties) - So being on a school sports team is an
example of leadership
- The more specific information you can provide for the committee, the better. Include the name of the
company/organization with which you worked, the nature and responsibilities of your position, etc.
-Include only projects/activities that are entirely distinct and separate from activities listed under the “Service” section
of your survey. (i.e. If you are president of a youth group that does service projects, you should use that activity for
either service or leadership—not both.)
Clarification: You must use examples that are entirely separate from the service activities listed in Section II.
For example, you cannot use President of National Charity League for leadership requirement and the service
hours done through the organization for your service requirement. Simply put, you need four different
groups/organizations/activities.
 Good Luck!!! 
2015-2016 National Honor Society Calendar
November 20th
Application Survey Packets Due
December 11th
Inductions Rehearsal (6:45AM, Auditorium):
Mandatory for all accepted applicants
December 16th
Inductions Ceremony (6PM, Auditorium):
Inductees should arrive at 5:30. Expect more information postacceptance.
Survey Materials Checklist:
In order to assist all applicants with the given survey, National Honor Society has included the following check-list to
ensure the inclusion of all necessary materials needed for the Faculty Board to review.
____ Student Signature and Parent/Guardian Signature
____ Character Paragraph
_____Required Essay
____ 2 Verification Statements for Service (Including Listed Information and Signatures)
____ 2 Verification Statements for Leadership (Including Listed Information and Signatures)
_____Google Form (Including Biography for Inductions) http://goo.gl/forms/yp9pg4yVRs
 Once again, we wish you the best of luck in your review for admission. 
If you have any questions, feel free to email me, Sonali Karmalkar, sonali.karmalkar@gmail.com