PENN MANOR CHAPTER

OF THE

NATIONAL HONOR SOCIETY

STUDENT ACTIVITY INFORMATION FORM

Directions: Please complete ALL sections (Please print in blue or black ink). Completion of this form does not guarantee selection. If there are any questions with the application form, please contact Mrs. Myers () or Mrs. Henderson () as soon as possible.

  1. Administrative Information

Name ______Phone ______

Email ______Grade 11 12

  1. Co-curricular Activities –

List all activities in which you have participated during high school. Include clubs, teams, musical groups, and major accomplishments in each.

Activity / 9 10 11 12 / Accomplishments
  1. Leadership Positions –

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 or motivating others should be included. For example, elected student body, class or club officer, committee chairperson, team captain, newspaper editor, work area manager or community leader.

Activity / 9 10 11 12 / Accomplishments
  1. Service Activities – contact information required

List service activities in which you have participated. These can be service projects done with a group either in or out of school or done as individual projects performing service. Generally speaking, service activities are those which are done for or on behalf of others (not including immediate family members) for which no compensation (monetary or other) has been given.

Date(s) / Nature of Service / Hrs. Estimate / Name of Supervisor / Phone Number
  1. Other Community Activities – contact information required

List other community activities in which you have participated and note any major accomplishment in each. These should be any activities outside of school in which you participated for the betterment of your community. For example, church groups, clubs sponsored outside the school, Boy or Girl Scouts or community art endeavors. Do not repeat participation already listed as Service Activities.

Date(s) / Nature of Service / Hrs. Estimate / Name of Supervisor / Phone Number
  1. Work Experience, Recognition, and Awards – (High School)

List below any job experience, academic honors, or recognition you have received that supports your bid to be selected for membership in the National Honor Society. Work experience may be paid or volunteer. (You may attach an additional sheet if needed.)

Job Title, Recognition or Award / 9 10 11 12 / Company, Organization or Presenter

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

Parent/Guardian ______Date ______

I understand that completing this form does not guarantee selection to NHS and acknowledge that the information presented here is accurate.

Student Signature ______Date ______

Please include your Fall schedule for contact purposes:

Class / Room / Teacher
Block 1
Block 2
Block 3
Block 4

NATIONAL HONOR SOCIETY

Criteria for Membership

ScholarshipAll students who have a cumulative grade point average of 3.85 (GPA) meet the scholarship requirements for membership in the Penn Manor Chapter of the National Honor Society. These students are eligible for consideration based on demonstration of leadership, service, and character.

Leadership

The student who exercises leadership:

Is resourceful in proposing new problems, applying principles, and making suggestions

Demonstrates leadership in promoting school activities

Exercises influence on peers in upholding school ideas

Contributes ideas that improve the civic life of the school

Is able to delegate responsibilities

Exemplifies positive attitude

Inspires positive behavior in others

Demonstrates academic initiative

Successfully holds offices or positions of responsibility, conducting business efficiently and effectively, and without prodding, demonstrates reliability and dependability

Demonstrates leadership in the classroom, at work, in school or community activities

Is thoroughly dependable in any responsibility accepted

Service

The student who serves:

Is willing to uphold scholarship and maintain a loyal school attitude

Participates in outside activities (i.e., scouts, church groups, volunteer services for the aged, poor, disadvantaged or unique family duties)

Volunteers dependable and well-organized assistance, is gladly available, and is willing to sacrifice to offer assistance

Works well with others and is willing to take on different or inconspicuous responsibilities

Cheerfully and enthusiastically renders any requested service to the school

Is willing to represent the class or school in inter-class and inter-scholastic competition

Does committee and staff work uncomplainingly

Shows courtesy by assisting visitors, teachers, and other students

Character

The students of character:

Takes constructive criticism willingly and accepts recommendations graciously

Consistently exemplifies desirable qualities of behavior (cheerfulness, friendliness, poise, stability)

Upholds principles of morality and ethics

Cooperates by complying with school regulations concerning property, programs, office halls, etc.

Demonstrates the highest standards of honesty and reliability

Shows courtesy, concern, and respect for others

Observes instructions and rules, punctuality, and faithfulness both inside and outside of the classroom

Has power of concentration and sustained attention as shown by perseverance and application to studies

Manifests truthfulness in acknowledging obedience to rules, avoiding cheating in written work, and showing unwillingness to profit by the mistakes of others

Actively helps to rid the school of bad influences or environments