Central Bucks High School South National Honor Society

Central Bucks High School South National Honor Society

Important Information for NHS Candidates:

*A Faculty Selection Committee determines membership based on established criteria:

· Academic achievement

· Service to school (as an ongoing commitment)

· Service to community

· Demonstration of leadership

· Character (no record of cheating, intentional dishonesty, violating school rules or civil offenses in the community)

Direction Guidelines:

* Carefully read the directions above each section of the information packet.

* Documentation is required for each section. Give yourself ample time to procure it.

* Only list activities and awards that were completed after ninth grade.

* Do not list the same activity in more than one category.

* Do not list activities in one section that are affiliated with clubs in another section.

* Do not attach anything you would like returned to you. Attach copies instead.

* All information should be typed on the forms provided.

* The student desiring membership must complete this form.

Forms and documentation must be submitted in a 9 x 12" envelope on September 19 (Thursday) or September 20 (Friday) to Mrs. Buzin in the cafeteria during Titan Forum only (no exceptions).

I certify that I completed the attached Activity Information Sheet, and the information I provided in the attached form is accurate and complete:

Name ______(please type)

Present Grade Level ______

Signature of Student ______Date ______

Signature of Parent/Guardian ______Date ______

Parent Email Address ______

Student Email Address ______

Information Sheet: #______(To be entered upon receipt of application)

Student will receive written verification noting the time and date of application submission.

Information Sheet #______(To be filled in by Mrs. Buzin)

Present Grade Level ______

Section I: GPA ______(To be filled in by Mrs. Buzin)

Section II: Leadership – School Involvement/Leadership Positions

List all school activities and circle the year or years in which you participated in them: clubs, teams, and certain musical groups are examples of school activities. Estimate the time you spend on each activity. Do not include activities you intend to participate in for the 2013-2014 school year.

***FOR EACH SCHOOL ACTIVITY, YOU MUST RETURN A SIGNED & SEALED "IN SCHOOL" EVALUATION FROM YOUR ADVISOR. (The "In-School Evaluation Form" is attached at the end of this packet. Make as many copies as needed for each activity.)

Sport, Club, or Activity Grade Advisor/Coach Signature

______10 11 12 ______

Elected/Appointed Leadership Roles in These Activities Advisor/Coach Signature

1. ______

2. ______

3. ______

Section III: Service to Community

DEFINITION: Community service activities are those that are done for or on the behalf of others (outside of family & school) for which no compensation has been given. Juniors are expected to have performed at least 10 hours of community service since the end of 9th grade. Seniors are expected to have performed at least 15 hours.

*** FOR THIS SECTION, YOU MUST GIVE AN "OUT-OF-SCHOOL" EVALUATION FORM TO A SUPERVISING ADULT FOR EACH COMMUNITY SERVICE ACTIVITY IN WHICH YOU PARTICIPATED. (The "Out-of-School evaluation Form" is attached at the end of this packet. Make as many copies as needed for each activity.)

Community Activity: ______Grade: 10 11 12

Number of hours per week: ______Number of weeks per year: ______

Adult Sponsor's Name: ______Sponsor's Phone #: ______

Sponsor's Address: ______

**Note**: If you participated in more than three community service activities, please feel free to make extra copies of this page

Section IV: Character

Use this section to describe any discipline incidents that resulted in you serving a detention or suspension at C.B. South. Give details about the incident, what you learned from it, and how you will prevent it from happening again.

______

REMINDER: Forms and documentation must be submitted in a 9 x 12" envelope on

September 19 or 20 to Mrs. Buzin in the cafeteria during Titan Forum only(no exceptions).

CENTRAL BUCKS SOUTH NATIONAL HONOR SOCIETY

IN-SCHOOL ACTIVITY/SPORT/CLUB EVALUATION FORM

The applicant is to fill in his/her name and provide an envelope to the advisor/coach. The advisor/coach should place the completed form in the envelope and SIGN THE SEAL OF THE ENVELOPE. The advisor/coach should then return the form to the applicant. If the seal is broken, the applicant will not be considered for admission into NHS.

Candidate Name: ______

Advisor/Coach (print and sign name):______

Activity Name: ______Member Since:______

****Please provide your SPECIFIC comments and Examples regarding this student and his or her demonstration of leadership, character, or participation for their National Honor Society application.

****Comments: ______

______

Do you recommend this student for admission into NHS? YES NO

YES, but with Reservations _____ Please explain ______

______

**Note to the applicant: Make copies for each activity/sport/club**

CENTRAL BUCKS SOUTH NATIONAL HONOR SOCIETY

OUT-OF-SCHOOL ACTIVITY FORM

The applicant is to fill in his/her name and give this form and an envelope to the ADULT community service sponsor. The sponsor should place the completed form in the envelope and SIGN THE SEAL OF THE ENVELOPE. The sponsor should then return the form to the applicant. If the seal is broken, the applicant will not be considered for admission into NHS.

TO BE COMPLETED BY THE APPLICANT:

Name of Member: ______

Community Service Activity: ______

Hours of Service: ______

Name/Phone Number of Sponsor: ______

Signature of Service Sponsor: ______

FOR THE SERVICE SPONSOR

We are considering a member of your activity for induction into the National Honor Society. For the purpose of examining their level of service, commitment, and leadership, the student should have requested from you a few words describing the service provided by the applicant and include any leadership roles that he/she fulfilled.

______

Do you recommend this student for admission into NHS? YES NO

YES, but with Reservations _____ Please explain ______

______

**Note to the applicant: Make copies for each community service activity**