National Honor Society

SPRINGFIELD HIGH SCHOOL NATIONAL HONOR SOCIETY APPLICATION Student Activities Information Form (3.5 GPA minimum)

Options: you may print a copy of this application and write in information or download the version available on the Media Center website: http://teachers.springfield-lucas.k12.oh.us/hathaway/. and type your answers.

Part I Personal Information:

Name ______Class of ______GPA______

Address ______SO. _____ JR. _____ SR. _____

Parents /Guardians______Phone ______

Counselor ______Month/year of enrollment at SHS ______

Email ______

Part II Personal Resume: A. Leadership: List the leadership roles you have held in your school and community within the last 2-3 years. There is a minimum of two different activities, one of which must be SHS related.

Organization Leadership Role 9 10 11 12 Name/Phone of Adult Supervisor

______

B. Service: List service activities you have participated in during the last 2-3 years. Service is defined as volunteer work with no monetary compensation or school credit. A minimum of two service activities is required.

Organization Service Performed Length of Time Involved Name/Phone of Adult Supervisor

______

C. Character: Share an experience that defines for you, and will reveal to the SHS faculty, the best essence of your character.

______

Part III Personal Appraisal: Be concise, specific, and complete in your responses.

A. In your opinion, what is the most important part of NHS/being a member of NHS? ______

______

B. Describe several ways in which you plan to contribute to the success of Springfield High School’s NHS chapter if you are selected for membership. ______

______

Part IV Personal Commitment: By completing and signing this form, you are accepting the responsibilities of membership as listed below.

1. I will participate in the formal induction ceremony, Monday, April 22, 2013. 2. I will attend ALL regularly scheduled meetings of National Honor Society on the first and third Thursday of the month. 3. I will participate in various committees and complete the code of conduct form. 4. I will participate in service projects required by National Honor Society. 5. I will adhere to the Standards of Participation set by Springfield High School of which 3 individual service hours per month are required, with proof of completion submitted by the 1st of each month.

I am willing to make a commitment to the National Honor Society of Springfield High School. I understand that my membership may be revoked if I do not meet these obligations.

Student Signature ______Date ______

Parent Signature ______Date ______

Completed forms must be returned to Mrs. Munn in room B173 or Mrs. Voorman in room D140-A no later than Friday, March 22, 2013 by 2:30 p.m. NO exceptions.