WOODSTOCK HIGH SCHOOL

NATIONAL HONOR SOCIETY

Kelly Burke, Adviser

Allen Domenico, Adviser

National Honor Society Application Checklist

o  Personal data page

o  Three teacher recommendation forms – complete the top portions only and deliver to your recommending teacher.

o  School Activity Information Form

o  Candidate Essay (final section of the Activity Information Form)

o  Signature page

Applications must be received by Monday, August 29, 2016

This is a firm deadline Technical problems are not an excuse. No reminders will be sent; no late applications will be reviewed.

Deliver to Ms. Burke Rm 730 or Mr. Domenico Rm 711

Woodstock High Chapter

National Honor Society Application

Personal Data

Name: ______

Last First Middle

Address: ______

Number and Street

______

City and State Zip Code

Home Telephone: ______Cellular Telephone: ______

E-mail:______

Have you ever had ISS or Alternative School, or Out-of-School Suspension? Yes ______No ______

If yes, please describe the circumstances in the space below.

General Directions: Use the checklist to be sure all parts of the application are included. Follow the specific directions on each page. Application pages may be completed online and then printed. Handwritten applications will not be accepted.

Incomplete applications will not be reviewed.

Return your completed application to Ms. Burke, Rm 730 or Mr. Domenico Rm 711.

Deadline: _Monday, August 29, 2016______

Teacher Recommendations: In the spaces below, name the three teachers you will ask to recommend you. Complete the table. A recommendation must be given to a teacher whose class you have taken or are currently taking. You cannot use a coach, activity sponsor, counselor or non-teaching staff person.

Teacher / Course / Semester /Year

Woodstock High School

National Honor Society Application

Teacher Recommendation Form

Applicant: Complete the top portion only.

Student Name: ______

Teacher Name: ______Student: DO NOT write below the dotted line

This student is seeking to become a member of the National Honor Society. The Faculty Council would like your input to help make its decision.

What course did you teach this student and when? ______

Check the appropriate box that best describes the character of the student.

Attribute / Truly Outstanding (top 2-3%) / Excellent
(Top 10%, but not top 2-3%) / Good / Average / Below Average / No Basis for Judgment
Responsibility
Maturity and self-discipline
Self-confidence
Sense of humor
Concern for others
Integrity
Reaction to setbacks
Compliance with school regulations
Cooperation with others

Recommendation: _____ recommend without reservation

_____ recommend with reservation (Please comment).

_____ do not recommend (Please comment).

Comments:______

Signature ______

Printed Name ______Date ______

DO NOT RETURN TO THE APPLICANT.

Please sign and return to the mailbox of Kelly Burke or Allen Domenico by Monday, August 29, 2016.

Thank you.


Woodstock High School

National Honor Society Application

Teacher Recommendation Form

Applicant: Complete the top portion only.

Student Name: ______

Teacher Name: ______Student: DO NOT write below the dotted line

This student is seeking to become a member of the National Honor Society. The Faculty Council would like your input to help make its decision.

What course did you teach this student and when? ______

Check the appropriate box that best describes the character of the student.

Attribute / Truly Outstanding (top 2-3%) / Excellent
(Top 10%, but not top 2-3%) / Good / Average / Below Average / No Basis for Judgment
Responsibility
Maturity and self-discipline
Self-confidence
Sense of humor
Concern for others
Integrity
Reaction to setbacks
Compliance with school regulations
Cooperation with others

Recommendation: _____ recommend without reservation

_____ recommend with reservation (Please comment).

_____ do not recommend (Please comment).

Comments:______

Signature ______

Printed Name ______Date ______

DO NOT RETURN TO THE APPLICANT.

Please sign and return to the mailbox of Kelly Burke or Allen Domenico by Monday, August 29, 2016.

Thank you.


Woodstock High School

National Honor Society Application

Teacher Recommendation Form

Applicant: Complete the top portion only.

Student Name: ______

Teacher Name: ______Student: DO NOT write below the dotted line

This student is seeking to become a member of the National Honor Society. The Faculty Council would like your input to help make its decision.

What course did you teach this student and when? ______

Check the appropriate box that best describes the character of the student.

Attribute / Truly Outstanding (top 2-3%) / Excellent
(Top 10%, but not top 2-3%) / Good / Average / Below Average / No Basis for Judgment
Responsibility
Maturity and self-discipline
Self-confidence
Sense of humor
Concern for others
Integrity
Reaction to setbacks
Compliance with school regulations
Cooperation with others

Recommendation: _____ recommend without reservation

_____ recommend with reservation (Please comment).

_____ do not recommend (Please comment).

Comments:______

Signature ______

Printed Name ______Date ______

DO NOT RETURN TO THE APPLICANT.

Please sign and return to the mailbox of Kelly Burke or Allen Domenico by Monday, August 29, 2016.

Thank you.


National Honor Society Student Activity Information Form

ID Number: / Grade:

I.  WHS Extra-Curricular Activities (school clubs, yearbook, newspaper, band, etc.)

Activity Club / Years of Participation / Leadership Position Held / Accomplishments
Awards / Activities / Advisors
9 / 10 / 11 / 12

II.  WHS Sports / Athletics

Sport / Years of Participation / Leadership Position Held / Accomplishments
Awards / Activities / Coach
9 / 10 / 11 / 12

III.  Community Activities (church groups, volunteer corps, boy / girl scouts, cultural work, sports, etc.)

Activity/Club/Sport / Years of Participation / Leadership Position Held / Accomplishments
Awards / Activities / Contact Person
and telephone #
9 / 10 / 11 / 12

IV.  Work Experience (any employment outside of school, paid or volunteer, including summers)

Type of Employment / Employer / Dates of Employment
Hours Per Week

V.  Honors, Awards, and Recognition

Award / Date Received / Description

VI.  Family Duties and Responsibilities (If applicable, describe any duties or responsibilities to your home and family which may influence your extra-curricular involvement).

VII. Essay- Write a short essay explaining what “Honor”, “Leadership”, and the National Honor Society mean to you. Include why you feel you would like to be a member of the NHS and how you could contribute to the goals and standards of the organization. Please limit your response to 300-500 words.

Word Count ______

I understand that completion of this form does not guarantee membership, but that I am being considered for membership in the National Honor Society.

______

Candidate’s Name

VIII. Signatures

I understand that completing and submitting this form does not guarantee selection to the National Honor Society. I attest that the information presented here is complete and accurate. If selected, I agree to abide by the standards and guidelines of the chapter and to fulfill all of my membership obligations to the best of my ability.

______

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.

______

Parent Signature Date

VIII. Declining Invitation

**If at this time you are not interested in pursuing membership into the National Honor Society please sign below and return this single sheet to either Ms Burke or Mr Domenico.

______

Student Signature Date

______

Parent Signature Date

All forms are to be returned to Ms Burke, RM 730 or Mr Domenico Rm 711 by Monday, August 29, 2016.