Columbia High School Chapter of the National Honor Society

COLUMBIA HIGH SCHOOL CHAPTER OF THE NATIONAL HONOR SOCIETY Directions: Please complete all sections. Information must be typed. Do not be modest; all information is needed by the Faculty Council to assist with the selection process. Completion of this form does not guarantee selection. Due Date: Monday, May 15, 2017 by 12:10 PM. Late applications will not be considered. I. Administrative Information Name:

II. Extra-Curricular Activities- List all activities in which you have participated during high school. Include CLUBS, TEAMS, MUSICAL GROUPS, etc., and MAJOR ACCOMPLISHMENTS IN EACH.

Activity Year (9, 10, 11, 12) Accomplishments

III. 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 Year (9, 10, 11, 12) Accomplishments

IV. Service Activities- 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. Please list the name of an adult supervisor who can verify your participation in each activity.

Activity Year (9, 10, 11, 12) Name and Phone Number of Adult Sponsor V. Other Community Activities- 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 above.

Community Year (9, 10, Hours/Week Major Name and Activity 11, 12) Accomplishments Phone Number of Adult Sponsor

VI: Work Experience, Recognition, and Awards- List below any job experiences, honors, or recognition that you have received that support your bid to be selected for membership in the National Honor Society. Work experience may be paid or volunteer.

Job, Recognition, or Year (9, 10, 11, 12) Explanation of Job, Award Recognition, or Award

VII: Character. In a multi-paragraph essay, explain to the faculty council how you are a person of character. To do this, explain, using specific examples from your life, how you demonstrate THREE of the “Six Pillars of Character.” These are: respect, responsibility, trustworthiness, fairness, caring, and citizenship. Your essay can be no more than one typed page with 1 inch margins. Place your name, as a header, in the upper right hand corner of your essay.

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

Student Signature Date

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 Signature Date This file is a template. Save the file by selecting “Save As.” Be sure to save it to your network folder or to a disk. Do not save it to the “NHS” folder because it will be deleted.

VERY IMPORTANT! Select PRINT LAYOUT under VIEW before you print to ensure that your table is not interrupted by a page break. Also, do not change the font or font size.