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St.
Elizabeth National Honor Society Student Activity Information Form Directions: Please complete all sections. Do not be modest. Every bit of information can be used by the Faculty Council to assist with the selection process. Completion of this form does not guarantee selection.
Service Hours Career GPA Date Junior Senior I. Administrative Information
Name___________________________________________________________
Address_________________________________________________________
II. Co-curricular Activities List all activities in which you have participated during high school. Include clubs, teams, musical groups, etc., and major accomplishments in each. Activity Year Accomplishments 9 10 11 12
III. Leadership Positions. List all elected or appointed leadership positions held in school, community, or work activities. Only those positions in which you were directly responsible for directing or motivating others should be included. For example, elected student body, class, or club officer; committee chairpersons; team captain; newspaper editor; work area manager; or community leaders. Activity Year Accomplishments 9 10 11 12
IV. Service Activities List service activities in which you have participated. These can be service projects done with a group either in or out of school, or done as individual projects performing service. 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) has been given. Please list the name of an adult supervisor who can verify your participation in each activity. Activity Year Adult Sponsor Signature 9 10 11 12
V. Other Community Activities List other community activities in which you have participated and note any major accomplishments in each. These should be any activities outside of school in which you participated for the betterment of your community. For example: church groups, club sponsored outside the school, Boy or Girl Scouts, or community art endeavors. Do not repeat participation already listed above. Community Year Hours/Week Major Signature of Activity 9 10 11 12 Accomplishments Adult Sponsor
VI. Work Experience, Recognition, and Awards List below any job experiences, honors, or recognition that you have received that support your bid to be selected for membership in the National Honor Society. Work experience may be paid or volunteer Job, Recognition or Award Year Group or Activity 9 10 11 12 Number of Hours Spent on Job or Volunteer Activity
I understand that completing this form does not guarantee selection to NHS, and that the information presented here is accurate.
____________________________________________________________________________ Student Signature Date
I have read the information provided by my son/daughter on this form and can verify that it is true. accurate and complete in its presentation.
____________________________________________________________________________ Parent Signature Date
Candidate Packet Due: in the office of Mrs. Gibbons, on Friday, October 3, 2008, no later than 2:00 p.m.
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