NJHS Application Packet

If you are interested in pursuing NJHS membership, you must complete and submit pages 1-3 of the attached student information packet. This includes:

1) Completingall sections as directed, 2) attaching an essay in the format described, and 3)attaching a letter of recommendation as detailed within the packet.

Completed forms must be turned in no later than March 31, 2014. Turn your forms into the front office and inform the front office staff you are turning in your NJHS forms. A box will be located in the front office for this purpose. Notifications will be sent home by April 25th.

  • Induction is planned for May12, 2014. You will be required to wear either a dress or shirt/tie (dark blue or black slacks or skirt/dress and white shirt). We will have two mandatory rehearsals prior to induction.
  • Membership dues are $10.00 per year, and should be paid yearly. These dues help cover the cost of the induction ceremony, and start up fees for community service projects. Inability to pay does not impact selection into the organization.
  • Inducted members are required to complete 4 community service/school service hours per grading period. This includes group projects and individual service projects.
  • Members are required to attend a scheduled monthly meeting, which will be determined following induction
  • Members who fail to uphold the standards of scholarship, leadership, character, citizenship or service may be considered for dismissal from Holly Shelter National Junior Honor Society.
  • The packet contains an “opt out” section for students who do not wish to pursue this opportunity (page 3).
  • If you are given a letter of non-selection, you may contact the chapter advisor () within 10 school days of notification of non-selection.

Student Information Sheet (page 1 of 3)

Name ______Homebase Teacher______Grade____

Completion of this form does not guarantee membership.

Please complete this from accurately. Do not be modest. The Faculty Council needs to know yourparticipation in activities.

Section 1: School-Based Activities at Holly Shelter (Service and Citizenship)

Note: Activities involve both time and effort on your part. Examples include but are not limited to: Science Olympiad Team, Battle of the Books, Broadcast team, Peer Mentor/tutoring, afterschool clubs, sports activities) Non-examples: Band/Chorus, Honor roll, donating food, etc.

Grade / Activity / Number of Months / Sponsor/Teacher
Signature

Section 2: Community-Based Activities (Service and Citizenship)

(Activities involve both time and effort on your part. Donating money is not an activity by itself.)

Grade / Activity / Number of Months / Sponsor/Teacher
Signature

Student Information Sheet (page 2 of 3)

Section 3: Leadership Positions since starting sixth grade (Leadership)

Grade / Activity / Number of Months / Sponsor/Teacher
Signature

Section 4: Excluding factors

1. Have you had any referrals to the office since the start of sixth grade? ______If, yes, was apunishment imposed? ______What was the referral for? ______

Explain: ______

2. Have you ever been in trouble with the law? ______Explain: ______

______

______

3. Have you had any U’s (Unsatisfactory) in conduct in the past year?__ Explain:

______

______

4. Did you enroll at Holly Shelter after the 1st day of school? ______Date of enrollment: ______

(Members must have been enrolled at least two grading periods.)

Section 5: Essay

Attach your typed 250-400-word essay on why you wish to be a member of the NJHS. The essay must start with: “I qualify to be a member of theHolly Shelter National Junior Honor Society because...”Include evidence of citizenship, scholarship, character, service, and leadership. You must use 1-inch margins,double space, and type the essay in number 12 font.

Applicant’s name must be in the upper righthand corner on every page.

Student Information Sheet (page 3 of 3)

Section 6: Letter of Recommendation should specifically address service, leadership, citizenship, scholarship and/or character.

Attach ONE signed letter of recommendation from one of your coaches, club sponsors or activity directors mentioned in sections 1, 2, or 3. It is your responsibility to contact, follow-up, get the letterand attach it to your application. The letter may not be written by a regular classroom teacher

unless he/she is also the sponsor or coach of one of your activities. The letter may not be written by a relative.

PLEASE be considerate and allow your coaches and sponsorsample time to write your letterof recommendation. You may want to contact more than one person in the event a coach or sponsor fails to write your letter of recommendation in a timely manner.

I understand that there is no guarantee that I will be selected for membership. To the best of my knowledge, the information in this student information sheet is true. If chosen, I fully understand the requirements forremaining a member in good standing in the Holly Shelter NJHS.

______

Student signature Parent signature

Student email: ______(Print neatly!)

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OPT OUT SECTION: Please complete this section if you do NOTwish to pursue membership in the NJHS at the current time.

At the present time, _(candidate name)______, will be unable to fulfill the obligations and requirements of the NJHS, or is not interested in becoming a member.

______

Student signature Parent signature