<p> Attach a recent photo to the upper right corner. National Honor Society Ray Waldo, Jr. Chapter Martinsburg High School</p><p>Student Application Form</p><p>Directions: Please complete all sections. Form must be fully typed and submitted in hard copy format to the NHS Advisor. Every bit of information may be used by the Faculty Council to assist with the selection process. Completion of this form does not guarantee selection. Please attach a recent photo to this application. No addenda may be added to this form. </p><p>I. Administrative Information</p><p>Full Legal Name: Street Address: City, State, Zip Code: Parent(s)/Guardian(s): Current Year (Grade): Social Media Account(s):</p><p>II. Scholarship *Leave 1 & 2 blank to be completed by the NHS Advisor.</p><p>1. Current Cumulative Grade Point Average: ______</p><p>2. Current Class Rank: ______of ______</p><p>3. Courses taken in high school: Please complete the chart listing courses under each heading. Please be sure to include Honors, AP, or other information if applicable. If you took/are taking different courses between semesters, address both in the respective row(s). </p><p>Grade 9 Grade 10 Grade 11 Grade 12 III. Co-Curricular Activities List all activities in which you have participated within high school. Include clubs, teams, musical groups, etc., and major accomplishments in each. Mark the years in which you participated in each with an “X”.</p><p>Activity Sponsor 9 10 11 12 Accomplishments</p><p>IV. 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 motivation others should be included. For example: student body, class, or club officer; committee chairperson; team captain; newspaper editor, work area manager, or community leader. Mark the years in which you participated in each with an “X”.</p><p>Activity Sponsor 9 10 11 12 Accomplishments V. School Service Activities List service activities in which you have participated. These can be service projects done with a group or individually within school. 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. Mark the years in which you participated in each with an “X”.</p><p>Activity Sponsor 9 10 11 12 Accomplishments</p><p>VI. Community Service Activities List community activities in which you have participated and note any major accomplishment in each. Use the definition above for what details a “service activity.” Example groups may include churches, clubs sponsored outside the school, Boy/Girl Scouts, or community art endeavors. Do not repeat participation already listed above. Mark the years in which you participated in each with an “X”.</p><p>1 1 Total Major Adult Supervisor’s Community Activity 9 10 1 2 Hours Accomplishments Signature VII. Work Experience, Recognition, and Awards List below any job experiences, honors, or recognition that you have received since the start of your freshman year. Work experience may be paid or volunteer.</p><p>Number of Hours Spent 1 Job, Recognition, or Award 9 10 12 Group or Activity on Job or Volunteer 1 Activity</p><p>VIII. Letters of Recommendation Attach two (2) dated and signed letters of recommendation for your acceptance into the National Honors Society. One (1) letter must be written by a teacher you have enrolled in a class with, and one (1) letter must be written by a community member (i.e. coach, advisor, boss/manager, sponsor, etc.). Each letter should be NO MORE than one page in length and highlight YOU and your exemplification of the Four Pillars of NHS; Leadership, Service, Character, and Scholarship)! More information of the Four Pillars can be found on the NHS section on the Martinsburg High School Website. (Please do NOT attach a Cover Letter or Resume to this application!)</p><p>IX. Signatures I understand that completing this form does not guarantee selection to NHS, and that the information presented here is accurate. I have read and understood the process by which the selection is completed. I agree to let this information enter this chapter’s selection pool understanding fully that my activity form will be supportive of my candidacy for membership to NHS.</p><p>______Student Signature Date</p><p>I have read the information provided by my son/daughter on this form and can verify that it is true, accurate, and complete in presentation. I also understand that this application does not guarantee selection to NHS. I have read and understood the process by which the selection process is completed. </p><p>______Parent Signature Date Thank you very much for taking the time to fill out this information, and congratulations on being selected as a National Honor Society nominee.</p>