Phoenixville Area High School Chapter
Candidate Credentials
Name: ______Grade: ______
Homeroom Teacher: ______Room: ______
Your Address: ______
______
Email Address: ______
Phone Number: ______
Elementary School Attended:______
National Honor Society membership is not based solely on academic achievement. NHS is an organization that recognizes outstanding individuals who are able to balance academics with other responsibilities and interests. NHS recognizes those well-rounded individuals who serve as positive role models and contributors to school life. Therefore, selection for membership is based upon evidence of the following four qualities: scholarship, service, leadership, and character. With membership come specific responsibilities, which have been outlined by the Faculty council (see membership responsibilities). Please consider them carefully before you turn in your credentials.
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I understand that completing this form does not guarantee selection to NHS and that the information presented here is accurate and will be circulated among faculty council members for review.
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Student Signature Date
I/We are aware of the requirements for application to NHS and recognize that failure to comply with these standards will disqualify this application. I/We have reviewed the application and selection procedure. I/We also understand that students selected to NHS must attend the meetings and functions as required. I/We recognize that students will be required to perform at least thirty hours of service. Students failing to comply will be removed from the Society for failing to maintain eligibility requirements.
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Parent(s) Signature(s)Date
NOTE: Please complete all sections. Type or print in blue or black ink all information. Do not be modest. Every bit of information will be used by the FacultyCouncil to assist with the fair consideration of your candidacy during the selection process. This credentials packet is the only information the Faculty Council will have when judging your credentials for possible membership. You will need to be very thorough and detailed. Completion and submission of this form does not guarantee selection. Should you have questionsabout this form, please contact Mrs. Weinstein at .
Section I:
Name______Date______Grade_____
Active email address: ______
Community Service: List service activities in which you have participated. These can be individual or group service projects done out of school. Generally, serviceactivities are those that are done for or on behalf of others (not including immediate family members) for which no compensation(monetary or otherwise) has been given.
School Service: List service activities in which you have participated. These can be individual or group service projects done in school. How have you benefitted your school community?
LEADERSHIP: List all elected or appointed leadership positions or other positions of responsibility held in school, community, or work activities. Only those positions in which you were responsible for directing or motivating others should be included.Please include the name of the adult responsible for supervising your leadership in each position.
CHARACTER: Your three letters of reference will be used in part to evaluate your character. Your name will be submitted to the entire faculty and staff of PAHS for a character evaluation. Your response to the following prompt will also be used in your character evaluation.
1.What attribute do you most admire about your character and what attribute do you least admire about your character? Provide at least two anecdotes about yourself that best illustrate yourmoralCHARACTER(be sure to address the definition pertaining to honesty, integrity, and ethical quality).
RECOGNITION OR AWARDS: List all other school-based activities (not noted above) in which you have participated in school. Include clubs, teams, musical groups, etc., and any significant accomplishments in each.
Name and describe any honors, recognition, or awards that you have received. Do not include honor roll.
Recognition or Awards / Year9 10 11 / Description
WORK EXPERIENCE: List any job experiencesthat support your bid to be selected for membership in the National Honor Society.
Work Experience / Year9 10 11 / Description
SPORTS OR CLUBS: Name and describe your involvement in any sports or clubs.
Sport or Club / Year9 10 11 / Description
Other Activities—List any other activities in which you have participatedfor the betterment of your school or community (e.g., religious groups, clubs sponsored outside the school, Boy or Girl Scouts, community art endeavors, etc.) and note any major accomplishment in each. Do not repeat participation already listed above. Please include the name of the adult supervisor of each activity.
Community Activity / Year9 10 11 / Accomplishments / Contact Person / Contact Information
Personal Statement:
This personal statement will help the Faculty Council become acquainted with you in ways different from your courses, grades, test scores, and other objective data. Use only the space provided.
1. Write about a personal aspect of your character that shows something unique about you that you have not been given the opportunity to showcase anywhere else on this application.
2. What do you see as the function of NHS? If selected to the Society, how will you contribute to the continued growth and success of the Society and the Phoenixville community?
*Be sure to submit the scoring rubric on pages 16-17 of this packet with your credentials. Write your name, grade, and elementary school attended on the top of the scoring rubric. The rubric should be the first page of your packet. Make sure you included your reference letters.
Membership acceptedMembership not granted
Total Score / /100
Candidate: ______
Grade: ______
Elementary School:______
Phoenixville Area High School National Honor Society Credentials Packet Rubric
Criteria / Excellent (4) / Good (3) / Fair (2) / Poor (1) / ScoreLEADERSHIP / Strong leadership experiences that put the candidate in charge of directing or motivating others. Involvement as a leader in two or more activities is very clear and over an extended period of time. / Sufficient Evidence of Leadership Qualities/Positions
Student shows leadership in two or more activities. / Minimal evidence of Leadership Qualities/
Positions
Student shows or has shown some leadership in one activity. / No evidence of leadership qualities/positions How the student was a leader is sketchy or unclear. Little evidence of leadership. / #1
#2
#3
#4
#5
COMMUNITY
SERVICE / Consistent, sustained, outstanding service and involvement to better our community in several areas. / Student evidences sustained service performed on an ongoing basis in one area . / Community service involvement is spotty. More one-time events than dedicated involvement. / How activities impact community is unclear. / #1
#2
#3
#4
#5
SCHOOL
SERVICE / Consistent, sustained, outstanding service and involvement to better our school community in several areas. / Student evidences sustained service performed on an ongoing basis in one area / School service involvement is spotty. More one-time events than dedicated involvement. / How activities impact school is unclear. / #1
#2
#3
#4
#5
CHARACTER
Student is a respectful, mature, responsible, fair, trustworthy, honest, good citizen. / Student shows strong evidence of exemplifying all of the seven desirable qualities of character. Is never rude or disrespectful. / Student shows good evidence of exemplifying most of the seven desirable qualities of character. Is never rude or disrespectful. / Student shows moderate evidence of the desirable qualities of character or has displayed an instance of poor judgment. / Student has frequently displayed poor judgment in their interactions with staff. They have displayed rude, or disrespectful behavior. / #1
#2
#3
#4
#5
Criteria / Excellent (4) / Good (3) / Fair (2) / Poor (1) / Score
Personal Statement #1
Personal Statement #2 / Writer does an exemplary job of explaining his /her character and why he/she would like
to be considered
for NHS. Statements are supported with specific examples
of how the
candidate meets
the qualifications
of character, leadership,
and service. / Writer does a good
job of explaining why
he/she would like to
be considered for
NHS. Statements are supported with some examples of how the candidate meets the qualifications of character, leadership, and service or the examples given are somewhat vague. / Writer does a
minimal job of
explaining why he/she would like
to be considered
for NHS. Some
statements are
not supported with
examples of how
the candidate
meets the qualifications of
character, leadership, and service or the examples given are vague. / Writer does not explain why he or she should be selected for membership / #1
#2
#3
#4
#5
If a Council member does not select a candidate for membership, please provide a reason why the candidate was not selected.
Council Member #1:
Council Member #2:
Council Member #3:
Council Member #4:
Council Member #5:
*The Faculty Council may make changes in the rubric as needed. For NHS records only.
NHS Selection Packet 2016-2017Page 1