San Ramon Valley High School

NHS Application

NATIONAL HONOR SOCIETY

Membership Packet

2017-2018 Academic Year

COVER SHEET

The National Honor Society originated as a means ‘to create enthusiasm for scholarship, to stimulate a desire to render service, to promote leadership, and to develop character in the students of secondary schools.’ This mission is fulfilled by rigorous participation in a myriad of community service projects throughout the academic year. Students in NHS display excellence in four distinct categories: character, scholarship, leadership and service. Your application will be evaluated with each of these four categories in mind. It is up to you, as an applicant, to use this form to its fullest possible extent and demonstrate to the Faculty Selection Committee that you are indeed dedicated to excellence in each of the aforementioned categories. Be specific, complete, and thorough. And be sure to attach any additional information on separate pieces of paper. As your achievements will be compared to those of each applicant, the fact that you complete the application does not ensure membership. Good luck!

NAME: ______YEAR OF GRADUATION:______

ADDRESS: ______CITY/ZIP: ______

PHONE NUMBER: ______E-MAIL ______

You will be submitting a packet of the following (descriptions/requirements for PART 1-5 start on p.2)

This cover sheet
PART 1: CHARACTER EVALUATION
PART 2: SCHOLARSHIP QUALIFICATION
PART 3: PERSONAL STATEMENT
PART 4: LEADERSHIP IN SCHOOL AND THE COMMUNITY (requires signatures)
PART 5: SERVICE TO SCHOOL AND THE COMMUNITY (requires signatures)
Evaluator Information Form (requires signatures)
Student/Parent Signature Form

Please carefully read the ‘Instructions for Submission’ handout

APPLICATIONS are DUE NO LATER THAN APRIL 11, 2017 to Mr. Melvin (room R-42)

LATE APPLICATIONS WILL NOT BE ACCEPTED

NATIONAL HONOR SOCIETY

Membership Packet

2017-2018 Academic Year

Instructions for Submission

I. In the event that an evaluator needs to mail in their form, please do the following:

Supply an envelope with appropriate postage to your evaluator
Make envelope out to:

San Ramon Valley High School/NHS

c/o Eric Melvin, Faculty Advisor

Re: Applicant’s Name (year of graduation)

501 Danville Blvd

Danville, CA 94526

II. Upon the completion of your membership packet, enclose it in a 9x12 inch manila envelope with your full name and year of graduation written in the upper, right-hand corner.

Include your sealed character evaluation envelopes, if not being directly mailed to school, along with the remainder of your packet in this order (from top to bottom):

Cover Sheet
Part 3: Personal Statement
Part 4: Leadership in School and the Community Log
Part 5: Service to School and the Community Log
Evaluator Information Form
Student/Parent Signature Form

III. Please put your manila envelope in Mr. Melvin’s mailbox (in the administration building) no later than Tuesday, April 11, 2017 at 3:30pm

(OR bring the envelope directly to Mr. Melvin’s room R-42)

LATE APPLICATIONS WILL NOT BE ACCEPTED

Membership Packet

2017-2018 Academic Year

Part 1-5 Explanation/Procedure

Part 1: Character Evaluation

Obtain the three recommendation forms which are titled: ‘Academic Subject Instructor Evaluation’, ‘Leadership Activity Observer Evaluation’, and ‘Community Service Observer Evaluation’. Please note the following guidelines:

Give each evaluator a 4x9 envelope in which to place your complete evaluation form. They may return by putting it in Mr. Melvin’s box in the front office, giving it to you, or mailing it to the school (see ‘ Instruction for Submission’ form if mailing).
The Academic Subject form must be given to a teacher you have had in an academic subject (math, history, science, foreign language, English) while in high school.
The Leadership Activity form must be given to anyone who has observed you in a leadership role requiring significant time commitment (coach, club advisor, teacher, employer, etc.). This form may not be completed by a family member or fellow student.
The Community Service form must be given to anyone who has observed you in a service role requiring significant time management (rabbi, priest, youth group advisor, volunteer project coordinator, coach, club advisor, etc. ). This form may not be completed by a family member or fellow student.
Members of the Faculty Selection Committee may not write a recommendation

Part 2: Scholarship Qualification

You must have a cumulative, weighted grade point average of at least 3.5 to be eligible for membership. Your G.P.A. will be verified by the club advisor. Please do not attempt to apply if you don’t meet this qualification.

Part 3: Personal Statement

Write a carefully constructed, succinct, and focused essay on the following prompt: ‘Tell us about yourself. Possible topics include but are not limited to: describe why you want to be a NHS member and what strengths you will bring to the organization, remark on your character, leadership, or service commitments. Please avoid lists of accomplishments. Sincerity, creativity, and humor are appreciated.’

Statement MUST be typed
No longer than 1 page (10 font, single spaced)

Part 4: Leadership in School and Community

Obtain the form titled ‘Leadership In School and the Community Log’, and follow the instructions

Part 5: Service to the School and Community

Obtain the form titled ‘Service To School and the Community Log’, and follow the instructions

EVALUATOR INFORMATION FORM

Academic /Character Evaluator

Name: ______Signature: ______

Title/Position: ______E-Mail ______

Street Address: ______

City/State/Zip ______Phone #______

Leadership/Character Evaluator

Name: ______Signature: ______

Title/Position: ______E-Mail ______

Street Address: ______

City/State/Zip ______Phone #______

Service/Character Evaluator

Name: ______Signature: ______

Title/Position: ______E-Mail ______

Street Address: ______

City/State/Zip ______Phone #______

Community Service Observer Evaluation

Due Date: Tuesday, April 11, 2017

Observer’s Name ______

Observer’s Signature ______

Student Information:

Name: ______Year of Graduation ______

Phone ______e-mail ______

The National Honor Society originated as a means ‘to create enthusiasm for scholarship, to stimulate a desire to render service, to promote leadership, and to develop character in the students of secondary schools.’ This mission is fulfilled by rigorous participation in a myriad of community service projects throughout the academic year. Students in NHS display excellence in four distinct categories: character, scholarship, leadership and service. This student’s application will be evaluated with each of these four categories in mind. Please comment on whether or not this student is qualified to be a member of the San Ramon Valley High School National Honor Society. Please be specific, as your evaluation is greatly appreciated and integral to the member selection process.

GENERAL EVALUATION (Please check one category)

(5)_____ Extremely well qualified. I recommend strongly and enthusiastically.

(4)_____ Well qualified. I recommend with confidence.

(3)_____ Qualified. I recommend with minor reservations

(2)_____ Possibly qualified. I recommend hesitantly and/or with doubt

(1)_____ Not qualified. I cannot recommend for membership

Comment and Explanation of General Evaluation

Please provide us with specific examples demonstrating reason for your recommendation. Please be specific in the community service provided and description of job responsibilities. You may use the space provided, using the back for additional comments, or attach a letter of recommendation.

[Place in sealed envelope]

Academic Subject Instructor Evaluation

Due Date: Tuesday, April 11, 2017

Teacher Name ______

Teacher Signature ______

Student Information:

Name: ______Year of Graduation ______

Course Name (most recent with evaluating teacher) ______

Phone ______e-mail ______

The National Honor Society originated as a means ‘to create enthusiasm for scholarship, to stimulate a desire to render service, to promote leadership, and to develop character in the students of secondary schools.’ This mission is fulfilled by rigorous participation in a myriad of community service projects throughout the academic year. Students in NHS display excellence in four distinct categories: character, scholarship, leadership and service. This student’s application will be evaluated with each of these four categories in mind. Please comment on whether or not this student is qualified to be a member of the San Ramon Valley High School National Honor Society. Please be specific, as your evaluation is greatly appreciated and integral to the member selection process.

GENERAL EVALUATION (Please check one category)

(5)_____ Extremely well qualified. I recommend strongly and enthusiastically.

(4)_____ Well qualified. I recommend with confidence.

(3)_____ Qualified. I recommend with minor reservations

(2)_____ Possibly qualified. I recommend hesitantly and/or with doubt

(1)_____ Not qualified. I cannot recommend for membership

Comment and Explanation of General Evaluation

Please provide us with specific examples demonstrating reason for your recommendation. Feel free to use the back of this form if more space is needed. You may attach a letter of recommendation if you prefer.

[Place in sealed envelope]

Leadership Activity Observer Evaluation

Due Date: Tuesday, April 11, 2017

Observer’s Name ______

Observer’s Signature ______

Student Information:

Name: ______Year of Graduation ______

Phone ______e-mail ______

The National Honor Society originated as a means ‘to create enthusiasm for scholarship, to stimulate a desire to render service, to promote leadership, and to develop character in the students of secondary schools.’ This mission is fulfilled by rigorous participation in a myriad of community service projects throughout the academic year. Students in NHS display excellence in four distinct categories: character, scholarship, leadership and service. This student’s application will be evaluated with each of these four categories in mind. Please comment on whether or not this student is qualified to be a member of the San Ramon Valley High School National Honor Society. Please be specific, as your evaluation is greatly appreciated and integral to the member selection process.

GENERAL EVALUATION (Please check one category)

(5)_____ Extremely well qualified. I recommend strongly and enthusiastically.

(4)_____ Well qualified. I recommend with confidence.

(3)_____ Qualified. I recommend with minor reservations

(2)_____ Possibly qualified. I recommend hesitantly and/or with doubt

(1)_____ Not qualified. I cannot recommend for membership

Comment and Explanation of General Evaluation

Please provide us with specific examples demonstrating reason for your recommendation. Please be specific in the leadership roles the applicant has undertaken. You may use the space provided, using the back for additional comments, or attach a letter of recommendation.

[Place in sealed envelope]

LEADERSHIP IN SCHOOL AND THE COMMUNITY LOG

(A resume may be submitted instead of this form, as long as it still has signatures)

PART 4: LEADERSHIP IN SCHOOL AND COMMUNITY

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 and motivating others and contributed a significant amount of energy and time should be included. For example: elected student body, class/club officer, committee chairperson, team captain, newspaper editor, work area manager, community leader. A supervising adult must verify participation.

You, the student, may fill in the information but an adult supervisor’s name and signature must accompany each individual position.

Leadership Position #1: ______

Organization/Affiliation: ______

Adult Supervisor: Name______Phone # ______

Signature ______

Grade level during participation (circle all that apply) 8 9 10 11

Brief Description:

Leadership Position #2: ______

Organization/Affiliation: ______

Adult Supervisor: Name______Phone # ______

Signature ______

Grade level during participation (circle all that apply) 8 9 10 11

Brief Description:

Leadership Position #3: ______

Organization/Affiliation: ______

Adult Supervisor: Name______Phone # ______

Signature ______

Grade level during participation (circle all that apply) 8 9 10 11

Brief Description:

_____ Put a check here if you have discussed more leadership positions on the reverse side.

_____ Put a check here if you have listed/described any AWARDS/HONORS you have received on the reverse side.

SERVICE TO SCHOOL AND THE COMMUNITY LOG

(A resume may be submitted instead of this form as long as it still has signatures)

PART 5: SERVICE TO SCHOOL AND THE COMMUNITY

List only school and community service activities to which you have contributed a significant amount of time and energy during your time in high school. Note any major accomplishments. These should be activities in which you participated for the betterment of others. For example: church groups, service clubs, Boy or Girl Scouts, volunteer groups, or other community endeavors. You may also include here any service rendered to the school via academic or athletic interscholastic competition. A supervising adult must verify participation

You, the student may fill in the information but an adult supervisor’s name and signature must accompany each individual position.

Service Position #1: ______# of Hours/participation ______

Adult Supervisor: Name ______phone # ______

Signature: ______

Grade level during participation (circle all that apply) 8 9 10 11

Brief Description: (include the purpose of your service and achievements, if applicable)

Service Position #2: ______# of Hours/participation ______

Adult Supervisor: Name ______phone # ______

Signature: ______

Grade level during participation (circle all that apply) 8 9 10 11

Brief Description: (include the purpose of your service and achievements, if applicable)

Service Position #3: ______# of Hours/participation ______

Adult Supervisor: Name ______phone # ______

Signature: ______

Grade level during participation (circle all that apply) 8 9 10 11

Brief Description: (include the purpose of your service and achievements, if applicable)

_____ Put a check here if you have discussed more service positions on the reverse side.

NATIONAL HONOR SOCIETY

Membership Packet

2017-2018 Academic Year

Student/Parent Signature Form

The National Honor Society originated as a means to create enthusiasm for scholarship, to stimulate a desire to render service, to promote leadership, and to develop character in the students of secondary schools.’ This mission is fulfilled by rigorous participation in a myriad of community service projects throughout the academic year. Students in NHS display excellence in four distinct categories: character, scholarship, leadership and service. Your application will be evaluated with each of these four categories in mind. It is up to you, as an applicant, to use this form to its fullest possible extent and demonstrate to the Faculty Selection Committee that you are indeed dedicated to excellence in each of the aforementioned categories. Be specific, complete, and thorough. And be sure to attach any additional information on separate pieces of paper. As your achievements will be compared to those of each applicant, the fact that you complete the application does not ensure membership. Good luck!

My parents and I have read the membership guidelines and fully understand that, if offered admission, I will uphold all responsibilities of the SRVHS National Honor Society. Included in these responsibilities are:

Regular attendance at meetings
Attendance at the induction ceremony for new members
Completion of NHS sponsored community service hours (5 active and 5 passive hours)
Completion of an Individual Service Project (30 hours with the same organization)

Date: ______

Student Name (print) ______Student Signature ______

Parent/Guardian Name ______Parent/Guardian Signature ______

APPLICATION DUE NO LATER THAN APRIL 11, 2017 to Mr. Melvin (R-42)