Old Quarry Middle School

Old Quarry Middle School

National Junior Honors Society

7th grade Nomination Packet Spring 2017

Attached is a copy of the nomination packet for NJHS. If selected to be a member of NJHS students will participate in the annual induction. After induction members will begin their membership in this service organization. Membership in NJHS comes with a great responsibility and should not be taken lightly. It is important that you have a heart for service to others. Students will be responsible for continuing their service minded activities through community and school service.

If accepted, in addition to maintaining an average of A-, each member is required to:

▪attend weekly meetings at 6:45a at OQMS,

▪participate in at least one group service activity outside of school,

▪complete 20 hours of community service outside of school, and

▪complete peer tutoring opportunities as assigned during the school day.

Directions:

Read carefully and complete all sections. You must type or print. A copy of this nomination packet is available on the NJHS website if you would like to type it using Microsoft Word. DO NOT BE MODEST. The information provided in this packet will be used by the Faculty Council to determine your eligibility for membership into NJHS, so please be as elaborate as you can about your accomplishments. Completion of this form does not guarantee selection. Be sure to turn in your completed forms, with required signatures, by Thursday, March 16tyhat 2:30p. Late applications may not be considered. Contact Mrs. Rickerson at r (630) 257-2286 ext. 4318 if you have any questions.

Student Name: ______

Current Grade: 7Advisory Teacher: ______

I understand that completing this form does not guarantee selection to NJHS, and that the information presented here is complete and accurate.

Student Signature ______ Date ______

I have read the information provided by my son/daughter on this form and can verify that it is accurate and complete in its presentation.

Parent Signature ______ Date ______

Applicant Name: ______7th Grade

Citizenship & Character: The student who demonstrates citizenship understands the importance of civic involvement and has a high regard for freedom, justice, and democracy. The student of good character upholds principles of morality and ethics, is cooperative, demonstrates high standards of honesty and reliability, shows courtesy, concern, and respect for others, and generally maintains a positive lifestyle. Staff in the building that currently interact with you will be asked to answer the following questions regarding their experiences with you this school year.

Please complete the statements below as a self-evaluation as to how you feel you have demonstrated the following characteristics throughout this school year. If you feel there is anything else that you would like to add regarding your citizenship & character, please add it to the comment section below.

Please rate yourself on a scale of 1-4, with 1 being least often demonstrated and 4 representing a consistently demonstrated behavior.

Please check the appropriate box.

Observations / 1 / 2 / 3 / 4
I am on time and prepared for class daily.
I am on task in each class daily.
I display a positive leadership role in class.
I respond to requests by staff appropriately.
I interact with peers in a positive manner.
I am respectful of my school environment.
I demonstrate appropriate behaviors in and out of the classroom.

If you feel there is anything else that you would like to add regarding your citizenship & character, please comment here.

Comments:

Applicant Name: ______

6th grade Activities:

List all activities that you were a part of during your 6th grade year. These can be activities from within the school or activities in your community. (If you have recently transferred into OQMS, list those activities from your previous school.) List everything you can think of like clubs, teams, athletics, band, choir, etc. Also, these could be any activity outside of school and school sponsored organizations, in which you have participated. You could include things such as: alter-serving, religious education, religious groups, music lessons, sports, clubs sponsored outside the school, Boy or Girl Scouts, music lessons, or community art endeavors.

Do not list service activities here.

List the name of an adult supervisor who can verify your participation in each activity. Also, include the approximate dates that the activity ran and how many hours per week that activity required your participation.

Be very detailed. This should be any activity completed during 6th grade or the summer going in to 6th grade.

Activity-description / Approximate dates of activity / # of Hours per week / Supervisor’s Name
Activity:
Description: / Start date:
End date:
Activity:
Description: / Start date:
End date:
Activity:
Description: / Start date:
End date:
Activity:
Description: / Start date:
End date:
Activity:
Description: / Start date:
End date:
Activity:
Description: / Start date:
End date:

Applicant Name:______

7th grade Activities:

List all activities that you were a part of during your 7th grade year. These can be activities from within the school or activities in your community. (If you have recently transferred into OQMS, list those activities from your previous school.) List everything you can think of like clubs, teams, athletics, band, choir, etc. Also, these could be any activity outside of school and school sponsored organizations, in which you have participated. You could include things such as: alter-serving, religious education, religious groups, music lessons, sports, clubs sponsored outside the school, Boy or Girl Scouts, music lessons, or community art endeavors.

Do not list service activities here.

Be very detailed. This should be any activity completed during 7th grade or the summer going in to 7th grade.

Applicant Name:______

Short Answer Response

Write or type a minimum of five sentences in response to the following questions. You may access this packet from the NJHS webpage under prospective members.

Service--

●How do you think you have been able to contribute to these organizations?

●What have you learned through your service to the school, community, or for others, and how have these experiences helped you?

Character:

●Define character.

●How do you demonstrate positive character in your everyday life?

Applicant Name: ______

Service

Below is a data sheet to record your hours of service to submit with your nomination packet for National Junior Honor Society. Prospective members should complete at least twenty (20) hours of community service during 6th and 7th grade. The NJHS webpage will provide you with detailed examples of acceptable service. Remember you cannot count more than 5 hours at any one event.

Note: If you already have a service hours log started you may substitute that page for this one and re-staple. Please describe your part in the service activity.

Date / Be detailed about your participation in the activity. / Location / Supervisor Name–Please have supervisor sign sheet and include phone number in which hours can be verified / Hours Comp-leted
Date: / Organization Name:
Activity: / Location: / Signature:
Phone: / Hours
Description of your role in this activity:
Date: / Organization Name:
Activity: / Location: / Signature:
Phone: / Hours
Description of your role in this activity:
Date: / Organization Name:
Activity: / Location: / Signature:
Phone: / Hours
Description of your role in this activity:
Date: / Organization Name:
Activity: / Location: / Signature:
Phone: / Hours
Description of your role in this activity:
Date: / Organization Name:
Activity: / Location: / Signature:
Phone: / Hours
Description of your role in this activity:

You can remove this page and attach your completed service hours log here.