Slinger Chapter of the

National Honor Society

(Student Activity Information Form)

Please complete all sections. Do not be modest. All information submitted will be used by the faculty council to assist with the selection process. However, submission of this form does NOT guarantee selection.

I.  Administrative Information (Please type or print in blue or black ink.)

Name:

Mailing Address:

Home Telephone:

I am a:

☐ junior ☐ senior

/ Attach a recent photo here

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 other should be included. Examples: elected student body, class, or club officer; committee chairperson; team captain; newspaper editor; work area manager; or community leader.

Activity or Organization / Year / Leadership Position
9 / 10 / 11 / 12

IV. Service and Community Activities:

List service and community activities in which you have participated, the years, the approximate total hours for each activity, and the name of the adult sponsor who can verify your participation in each activity. 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 that are done for or on behalf of others (not including immediate family members) for which no compensation (monetary or otherwise) has been given.

Activity / Year / # of hours / Name of adult sponsor
9 / 10 / 11 / 12

V. Work experience, recognition, and awards:

List below any job experiences, honors, or recognitions that you have received which support your bid to be selected for membership in the National Honor Society. Work experience may be paid or volunteer.

Job, group, activity / Year / # of hours / Recognition or award
9 / 10 / 11 / 12

VI. Brief Narrative:

Taking into account the activities you listed under “leadership,” describe your

leadership style. How do YOU lead?

I understand that completion of this information does not guarantee membership, but that I am being considered for membership in the National Honor Society. I will accept the decision of the faculty council charged with the responsibility of selecting members as final.

______

applicant signature date

We understand that the complete of this information does not guarantee membership, but that my son or daughter is being considered for membership in the National Honor Society. We will accept the decision of the faculty council charged with the responsibility of selecting members as final.

______

parent signature parent signature date

Please proofread your form. Make sure it looks professional.