Practice NHS Student Activity Information Form

Transcription

1 Practice NHS Student Activity Information Form Use this practice file to Complete and print the 4 leadership forms in order to hand them to the adult supervisor who will verify your leadership and turn them in. 2. Complete all other questions and save responses for later copy and paste into the official online form. 3. Once you are ready, you will need to officially submit your form ONLINE using the link on the left of the NHS page. This needs to be done in one sitting. DIRECTIONS: Please complete all pages of this online information form. The deadline to submit your information is 2:30 pm, on Monday February 22, No late entries will be accepted. Your responses will be reviewed by a faculty council in order to determine those students accepted for membership. Completion of this online form does not guarantee selection. 1. Enter your first name, last name, and ID number* Student Name First Name Last Name ID number 2. Select your grade* There will be a drop down menu for you to select grade 11 or 12.

2 3. SECTION I. Leadership: On the pages that follow please explain 4 instances when you have taken on a leadership role. Evidence of leadership may be demonstrated through an elected or appointed position held in school, community, or work activities. The Wheaton North Faculty Council will be looking for evidence of leadership within Wheaton North. Only those positions in which you were responsible for directing or motivating others should be included. Examples of such leadership positions include but are not limited to: elected officer for the student body, class, or club; committee chairperson, team captain; newspaper or yearbook editor; section leaders in band or chorus; work area manager; or other community leader. If you choose a classroom experience as evidence of leadership, make sure to list evidence indicating how you went above and beyond what is expected of students in the class. On each of the next 4 pages, you will be completing the top half of the form and then printing the page and handing it to an adult supervisor who can verify your leadership experience. The adult supervisor will complete the bottom half. The forms need to be turned in directly to: Ms. Angela Raso, Wheaton North NHS Advisor, 701 W. Thomas, Wheaton, IL by the application deadline (Feb. 22, 2016). If you are giving it to a community leader it is recommended that you provide them with a stamped envelope.

3 SECTION I. Leadership Form 1 According to the official site of the National Honor Society, Student leaders are those who are resourceful, good problem solvers, promoters of school activities, idea-contributors, dependable, and persons who exemplify positive attitudes about life. Leadership experiences can be drawn from school or community activities while working with or for others. The following list of leadership qualities will be used as criteria for showing adequate evidence of leadership. In order for a leadership role to be considered sufficient it should include multiple items from the list. The student who exercises leadership: Is resourceful in proposing new problems, applying principles and making suggestions; Demonstrates initiative in promoting school activities; Exercises positive influence on peers in upholding school ideals and spirit; Contributes ideas that improve the civic life of the school; Is able to delegate responsibilities; Exemplifies positive attitudes; Inspires positive behavior in others; Demonstrates academic initiative; Successfully holds school offices or positions of responsibility; Conducts business effectively and efficiently; Demonstrates reliability and dependability; Is a leader in the classroom, at work, or in other school or community activities; Is dependable in any responsibility accepted ; Is able to motivate others; Is able to effectively communicate what needs to be done and give clear directions on how to do it; Listens to the concerns and questions of those that are being led; Sets short and long terms goals; Can accurately assess progress made and make necessary adjustments; Models desired behavior Name: Activity or Organization: Leadership Position or Role: Year in school while performing leadership role (9, 10, 11, 12 list one or multiple): In 50 words or less describe the leadership responsibility. This may be done in complete sentences or in list form. THIS SECTION TO BE COMPLETED BY SUPERVISING ADULT: Note: For additional information about the NHS leadership requirement refer to the list at the top of the page. NAME: TITLE: PHONE: 1.) How long have you known the student? 2.) Is the above information regarding the candidate s evidence of leadership accurate? Yes or No Comments: Please attach additional comments or use the back of this paper, if desired. 3.) Has the leadership you observed during your interaction with this student met the standard of NHS? Yes or No Signature of Adult Supervisor: Date: Supervisors, please turn form directly to: Ms. Angela Raso, Wheaton North H.S, 701 W. Thomas, Wheaton, IL (Angela.Raso@cusd200.org) by the deadline. ( )

4 SECTION I. Leadership Form 2 According to the official site of the National Honor Society, Student leaders are those who are resourceful, good problem solvers, promoters of school activities, idea-contributors, dependable, and persons who exemplify positive attitudes about life. Leadership experiences can be drawn from school or community activities while working with or for others. The following list of leadership qualities will be used as criteria for showing adequate evidence of leadership. In order for a leadership role to be considered sufficient it should include multiple items from the list. The student who exercises leadership: Is resourceful in proposing new problems, applying principles and making suggestions; Demonstrates initiative in promoting school activities; Exercises positive influence on peers in upholding school ideals and spirit; Contributes ideas that improve the civic life of the school; Is able to delegate responsibilities; Exemplifies positive attitudes; Inspires positive behavior in others; Demonstrates academic initiative; Successfully holds school offices or positions of responsibility; Conducts business effectively and efficiently; Demonstrates reliability and dependability; Is a leader in the classroom, at work, or in other school or community activities; Is dependable in any responsibility accepted ; Is able to motivate others; Is able to effectively communicate what needs to be done and give clear directions on how to do it; Listens to the concerns and questions of those that are being led; Sets short and long terms goals; Can accurately assess progress made and make necessary adjustments; Models desired behavior Name: Activity or Organization: Leadership Position or Role: Year in school while performing leadership role (9, 10, 11, 12 list one or multiple): In 50 words or less describe the leadership responsibility. This may be done in complete sentences or in list form. THIS SECTION TO BE COMPLETED BY SUPERVISING ADULT: Note: For additional information about the NHS leadership requirement refer to the list at the top of the page. NAME: TITLE: PHONE: 1.) How long have you known the student? 2.) Is the above information regarding the candidate s evidence of leadership accurate? Yes or No Comments: Please attach additional comments or use the back of this paper, if desired. 3.) Has the leadership you observed during your interaction with this student met the standard of NHS? Yes or No Signature of Adult Supervisor: Date: Supervisors, please turn form directly to: Ms. Angela Raso, Wheaton North H.S, 701 W. Thomas, Wheaton, IL (Angela.Raso@cusd200.org) by the deadline. ( )

5 SECTION I. Leadership Form 3 According to the official site of the National Honor Society, Student leaders are those who are resourceful, good problem solvers, promoters of school activities, idea-contributors, dependable, and persons who exemplify positive attitudes about life. Leadership experiences can be drawn from school or community activities while working with or for others. The following list of leadership qualities will be used as criteria for showing adequate evidence of leadership. In order for a leadership role to be considered sufficient it should include multiple items from the list. The student who exercises leadership: Is resourceful in proposing new problems, applying principles and making suggestions; Demonstrates initiative in promoting school activities; Exercises positive influence on peers in upholding school ideals and spirit; Contributes ideas that improve the civic life of the school; Is able to delegate responsibilities; Exemplifies positive attitudes; Inspires positive behavior in others; Demonstrates academic initiative; Successfully holds school offices or positions of responsibility; Conducts business effectively and efficiently; Demonstrates reliability and dependability; Is a leader in the classroom, at work, or in other school or community activities; Is dependable in any responsibility accepted ; Is able to motivate others; Is able to effectively communicate what needs to be done and give clear directions on how to do it; Listens to the concerns and questions of those that are being led; Sets short and long terms goals; Can accurately assess progress made and make necessary adjustments; Models desired behavior Name: Activity or Organization: Leadership Position or Role: Year in school while performing leadership role (9, 10, 11, 12 list one or multiple): In 50 words or less describe the leadership responsibility. This may be done in complete sentences or in list form. THIS SECTION TO BE COMPLETED BY SUPERVISING ADULT: Note: For additional information about the NHS leadership requirement refer to the list at the top of the page. NAME: TITLE: PHONE: 1.) How long have you known the student? 2.) Is the above information regarding the candidate s evidence of leadership accurate? Yes or No Comments: Please attach additional comments or use the back of this paper, if desired. 3.) Has the leadership you observed during your interaction with this student met the standard of NHS? Yes or No Signature of Adult Supervisor: Date: Supervisors, please turn form directly to: Ms. Angela Raso, Wheaton North H.S, 701 W. Thomas, Wheaton, IL (Angela.Raso@cusd200.org) by the deadline. ( )

6 SECTION I. Leadership Form 4 According to the official site of the National Honor Society, Student leaders are those who are resourceful, good problem solvers, promoters of school activities, idea-contributors, dependable, and persons who exemplify positive attitudes about life. Leadership experiences can be drawn from school or community activities while working with or for others. The following list of leadership qualities will be used as criteria for showing adequate evidence of leadership. In order for a leadership role to be considered sufficient it should include multiple items from the list. The student who exercises leadership: Is resourceful in proposing new problems, applying principles and making suggestions; Demonstrates initiative in promoting school activities; Exercises positive influence on peers in upholding school ideals and spirit; Contributes ideas that improve the civic life of the school; Is able to delegate responsibilities; Exemplifies positive attitudes; Inspires positive behavior in others; Demonstrates academic initiative; Successfully holds school offices or positions of responsibility; Conducts business effectively and efficiently; Demonstrates reliability and dependability; Is a leader in the classroom, at work, or in other school or community activities; Is dependable in any responsibility accepted ; Is able to motivate others; Is able to effectively communicate what needs to be done and give clear directions on how to do it; Listens to the concerns and questions of those that are being led; Sets short and long terms goals; Can accurately assess progress made and make necessary adjustments; Models desired behavior Name: Activity or Organization: Leadership Position or Role: Year in school while performing leadership role (9, 10, 11, 12 list one or multiple): In 50 words or less describe the leadership responsibility. This may be done in complete sentences or in list form. THIS SECTION TO BE COMPLETED BY SUPERVISING ADULT: Note: For additional information about the NHS leadership requirement refer to the list at the top of the page. NAME: TITLE: PHONE: 1.) How long have you known the student? 2.) Is the above information regarding the candidate s evidence of leadership accurate? Yes or No Comments: Please attach additional comments or use the back of this paper, if desired. 3.) Has the leadership you observed during your interaction with this student met the standard of NHS? Yes or No Signature of Adult Supervisor: Date: Supervisors, please turn form directly to: Ms. Angela Raso, Wheaton North H.S, 701 W. Thomas, Wheaton, IL (Angela.Raso@cusd200.org) by the deadline. ( )

7 Section 2: Service Activities List service activities in which you have participated. Also provide a brief description of the service and the time required. These can be service projects done with a group (i.e. other honor societies, Key club, Falcon Ambassadors) either in or out of school, or done as an individual 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. Junior candidates need a minimum of 30 documented hours to be considered for membership. Senior candidates need a minimum of 50 documented hours to be considered for membership. These hours can accumulate throughout high school. Please list the name of an adult supervisor who can verify your participation in each activity and include contact information for that sponsor (phone number/ ). Special notes about service: KEY CLUB can be used for the service category or as an extra-curricular but not both. FALCON AMBASSADORS can also be used for the service category only if service listed is ABOVE the yearly requirement for this club. Any hours listed for Relay for Life need to be related to the time spent ACTUALLY RAISING money, not time spent at the event. If you want to put down anything greater than 2 hours for Relay for Life you must provide documentation indicating what you did that took more than 2 hours (this may apply to captains or event organizers). 39. Name of Activity: 40. Year(s) involved in service activity: 41. Number of hours spent doing service: 42. Name of Adult Sponsor: 43. Contact Information for Adult Sponsor (phone/ ) 44. Description of Service, BE VERY SPECIFIC Skip ahead to page 15 of the online form if you are done entering your service activities.

8 Section 2: Service Activities List service activities in which you have participated. Also provide a brief description of the service and the time required. These can be service projects done with a group (i.e. other honor societies, Key club, Falcon Ambassadors) either in or out of school, or done as an individual 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. Junior candidates need a minimum of 30 documented hours to be considered for membership. Senior candidates need a minimum of 50 documented hours to be considered for membership. These hours can accumulate throughout high school. Please list the name of an adult supervisor who can verify your participation in each activity and include contact information for that sponsor (phone number/ ). Special notes about service: KEY CLUB can be used for the service category or as an extra-curricular but not both. FALCON AMBASSADORS can also be used for the service category only if service listed is ABOVE the yearly requirement for this club. Any hours listed for Relay for Life need to be related to the time spent ACTUALLY RAISING money, not time spent at the event. If you want to put down anything greater than 2 hours for Relay for Life you must provide documentation indicating what you did that took more than 2 hours (this may apply to captains or event organizers). 45. Name of Activity: 46. Year(s) involved in service activity: 47. Number of hours spent doing service: 48. Name of Adult Sponsor: 49. Contact Information for Adult Sponsor (phone/ ) 50. Description of Service, BE VERY SPECIFIC Skip ahead to page 15 of the online form if you are done entering your service activities.

9 Section 2: Service Activities List service activities in which you have participated. Also provide a brief description of the service and the time required. These can be service projects done with a group (i.e. other honor societies, Key club, Falcon Ambassadors) either in or out of school, or done as an individual 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. Junior candidates need a minimum of 30 documented hours to be considered for membership. Senior candidates need a minimum of 50 documented hours to be considered for membership. These hours can accumulate throughout high school. Please list the name of an adult supervisor who can verify your participation in each activity and include contact information for that sponsor (phone number/ ). Special notes about service: KEY CLUB can be used for the service category or as an extra-curricular but not both. FALCON AMBASSADORS can also be used for the service category only if service listed is ABOVE the yearly requirement for this club. Any hours listed for Relay for Life need to be related to the time spent ACTUALLY RAISING money, not time spent at the event. If you want to put down anything greater than 2 hours for Relay for Life you must provide documentation indicating what you did that took more than 2 hours (this may apply to captains or event organizers). 51. Name of Activity: 52. Year(s) involved in service activity: 53. Number of hours spent doing service: 54. Name of Adult Sponsor: 55. Contact Information for Adult Sponsor (phone/ ) 56. Description of Service, BE VERY SPECIFIC Skip ahead to page 15 of the online form if you are done entering your service activities.

10 Section 2: Service Activities List service activities in which you have participated. Also provide a brief description of the service and the time required. These can be service projects done with a group (i.e. other honor societies, Key club, Falcon Ambassadors) either in or out of school, or done as an individual 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. Junior candidates need a minimum of 30 documented hours to be considered for membership. Senior candidates need a minimum of 50 documented hours to be considered for membership. These hours can accumulate throughout high school. Please list the name of an adult supervisor who can verify your participation in each activity and include contact information for that sponsor (phone number/ ). Special notes about service: KEY CLUB can be used for the service category or as an extra-curricular but not both. FALCON AMBASSADORS can also be used for the service category only if service listed is ABOVE the yearly requirement for this club. Any hours listed for Relay for Life need to be related to the time spent ACTUALLY RAISING money, not time spent at the event. If you want to put down anything greater than 2 hours for Relay for Life you must provide documentation indicating what you did that took more than 2 hours (this may apply to captains or event organizers). 57. Name of Activity: 58. Year(s) involved in service activity: 59. Number of hours spent doing service: 60. Name of Adult Sponsor: 61. Contact Information for Adult Sponsor (phone/ ) 62. Description of Service, BE VERY SPECIFIC Skip ahead to page 15 of the online form if you are done entering your service activities.

11 Section 2: Service Activities List service activities in which you have participated. Also provide a brief description of the service and the time required. These can be service projects done with a group (i.e. other honor societies, Key club, Falcon Ambassadors) either in or out of school, or done as an individual 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. Junior candidates need a minimum of 30 documented hours to be considered for membership. Senior candidates need a minimum of 50 documented hours to be considered for membership. These hours can accumulate throughout high school. Please list the name of an adult supervisor who can verify your participation in each activity and include contact information for that sponsor (phone number/ ). Special notes about service: KEY CLUB can be used for the service category or as an extra-curricular but not both. FALCON AMBASSADORS can also be used for the service category only if service listed is ABOVE the yearly requirement for this club. Any hours listed for Relay for Life need to be related to the time spent ACTUALLY RAISING money, not time spent at the event. If you want to put down anything greater than 2 hours for Relay for Life you must provide documentation indicating what you did that took more than 2 hours (this may apply to captains or event organizers). 63. Name of Activity: 64. Year(s) involved in service activity: 65. Number of hours spent doing service: 66. Name of Adult Sponsor: 67. Contact Information for Adult Sponsor (phone/ ) 68. Description of Service, BE VERY SPECIFIC Skip ahead to page 15 of the online form if you are done entering your service activities.

12 Section 2: Service Activities List service activities in which you have participated. Also provide a brief description of the service and the time required. These can be service projects done with a group (i.e. other honor societies, Key club, Falcon Ambassadors) either in or out of school, or done as an individual 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. Junior candidates need a minimum of 30 documented hours to be considered for membership. Senior candidates need a minimum of 50 documented hours to be considered for membership. These hours can accumulate throughout high school. Please list the name of an adult supervisor who can verify your participation in each activity and include contact information for that sponsor (phone number/ ). Special notes about service: KEY CLUB can be used for the service category or as an extra-curricular but not both. FALCON AMBASSADORS can also be used for the service category only if service listed is ABOVE the yearly requirement for this club. Any hours listed for Relay for Life need to be related to the time spent ACTUALLY RAISING money, not time spent at the event. If you want to put down anything greater than 2 hours for Relay for Life you must provide documentation indicating what you did that took more than 2 hours (this may apply to captains or event organizers). 69. Name of Activity: 70. Year(s) involved in service activity: 71. Number of hours spent doing service: 72. Name of Adult Sponsor: 73. Contact Information for Adult Sponsor (phone/ ) 74. Description of Service, BE VERY SPECIFIC Skip ahead to page 15 of the online form if you are done entering your service activities.

13 Section 2: Service Activities List service activities in which you have participated. Also provide a brief description of the service and the time required. These can be service projects done with a group (i.e. other honor societies, Key club, Falcon Ambassadors) either in or out of school, or done as an individual 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. Junior candidates need a minimum of 30 documented hours to be considered for membership. Senior candidates need a minimum of 50 documented hours to be considered for membership. These hours can accumulate throughout high school. Please list the name of an adult supervisor who can verify your participation in each activity and include contact information for that sponsor (phone number/ ). Special notes about service: KEY CLUB can be used for the service category or as an extra-curricular but not both. FALCON AMBASSADORS can also be used for the service category only if service listed is ABOVE the yearly requirement for this club. Any hours listed for Relay for Life need to be related to the time spent ACTUALLY RAISING money, not time spent at the event. If you want to put down anything greater than 2 hours for Relay for Life you must provide documentation indicating what you did that took more than 2 hours (this may apply to captains or event organizers). 75. Name of Activity: 76. Year(s) involved in service activity: 77. Number of hours spent doing service: 78. Name of Adult Sponsor: 79. Contact Information for Adult Sponsor (phone/ ) 80. Description of Service, BE VERY SPECIFIC Skip ahead to page 15 of the online form if you are done entering your service activities.

14 Section 2: Service Activities List service activities in which you have participated. Also provide a brief description of the service and the time required. These can be service projects done with a group (i.e. other honor societies, Key club, Falcon Ambassadors) either in or out of school, or done as an individual 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. Junior candidates need a minimum of 30 documented hours to be considered for membership. Senior candidates need a minimum of 50 documented hours to be considered for membership. These hours can accumulate throughout high school. Please list the name of an adult supervisor who can verify your participation in each activity and include contact information for that sponsor (phone number/ ). Special notes about service: KEY CLUB can be used for the service category or as an extra-curricular but not both. FALCON AMBASSADORS can also be used for the service category only if service listed is ABOVE the yearly requirement for this club. Any hours listed for Relay for Life need to be related to the time spent ACTUALLY RAISING money, not time spent at the event. If you want to put down anything greater than 2 hours for Relay for Life you must provide documentation indicating what you did that took more than 2 hours (this may apply to captains or event organizers). 81. Name of Activity: 82. Year(s) involved in service activity: 83. Number of hours spent doing service: 84. Name of Adult Sponsor: 85. Contact Information for Adult Sponsor (phone/ ) 86. Description of Service, BE VERY SPECIFIC

15 87. Enter the total number of service hours from the previous pages:*

16 Section 3: School Sponsored Extracurriculars **Extra-Curricular Activities: Finally, in addition to the classroom, Wheaton North believes that much of students character and leadership is demonstrated through their involvement in extra-curricular activities. Therefore, it is the committee s recommendation that: junior students being reviewed for selection will provide evidence that they were a major contributor to at least 4 school sponsored extracurricular activities over the span of their high school years. (for example: football 9, 10, student council 10, yearbook 10 OR soccer 9, 10, 11, newspaper 10) senior students being reviewed for selection will provide evidence that they were a major contributor to at least 5 school sponsored extracurricular activities over the span of their high school years. Being a major contributor means that the student attends regular meetings and/or practices as well as fulfills the activity requirements defined by the coach or sponsor. Below is the list of school sponsored extracurricular activities. Classes at Wheaton North (i.e. choir, orchestra, etc.) and other honor organizations (i.e. Mu Alpha Theta, Foreign Language Honor Societies, etc.) are not considered extracurricular activities. CLUBS: Amnesty International, Anglers Club, Nat l Art H.S., Architecture Club, Chess Team, Courtyard Club, Déjà Vu, Environmental Rescue, Falcon Ambassadors (note: Ambassadors can also be used for the service category only if service listed is above the yearly requirement), Falcon Athletic Leadership Council, Falcon Sports Network, Falcon Weekly, Flock (note: Flock can be used for the service category or as an extracurricular but not both), Future Doctors of America, Habitat for Humanity, High Schools Against Cancer (HSAC), Hockey, Improv Club, Key Club (note: Key club can be used for the service category or as an extra-curricular but not both), LaCrosse (Boys), LaCrosse (Girls), Math Team, Mock Trial Club, Mosaic, Multicultural Club, Newspaper (Falcon Flyer), O.L.A.S., P.A.W.S., Pep Club, Scholastic Bowl, Science Club, Smash Club, Spanish Club, Student Council (note: Student Council point totals will be evaluated as evidence of adequate involvement), SSMS (Student Support Military Service), True North Stars (SODA), Ultimate Frisbee Club, Yearbook MUSIC: Colorguard, Jazz Bands 1 & 2, Marching Band, Pit Orchestra, Show Choir-Flight PERFORMING ARTS: Fall play, Spring Musical, Speech Team, Technology Club (Stage Crew/Set Design), One Act Plays DANCE: Falconettes Dance Team, Steppers Club GIRLS ATHLETICS: Badminton, Basketball, Cross Country, Cheerleading, Golf, Gymnastics, Soccer, Softball, Swimming, Tennis, Track, Volleyball BOYS ATHLETICS: Baseball, Basketball, Cross Country, Football, Golf, Gymnastics, Soccer, Swimming, Tennis, Track, Volleyball, Wrestling 88. Name of Activity: 89. If you selected "other" above, specify the name of the activity. Keep in mind that only the activities on the list are recognized by the faculty committee as school sponsored extra-curricular activities. 90. Year(s) in which you participated in the activity: 91. Total hours spent in activity per school year: 92. Contributions (i.e. attended meetings/practices, high scorer during game, captain, officer, committee chairperson) 93. Name of adult sponsor/coach: If you are finished entering your extra-curricular activities, skip ahead to page 22.

17 Section 3: School Sponsored Extracurriculars **Extra-Curricular Activities: Finally, in addition to the classroom, Wheaton North believes that much of students character and leadership is demonstrated through their involvement in extra-curricular activities. Therefore, it is the committee s recommendation that: junior students being reviewed for selection will provide evidence that they were a major contributor to at least 4 school sponsored extracurricular activities over the span of their high school years. (for example: football 9, 10, student council 10, yearbook 10 OR soccer 9, 10, 11, newspaper 10) senior students being reviewed for selection will provide evidence that they were a major contributor to at least 5 school sponsored extracurricular activities over the span of their high school years. Being a major contributor means that the student attends regular meetings and/or practices as well as fulfills the activity requirements defined by the coach or sponsor. Below is the list of school sponsored extracurricular activities. Classes at Wheaton North (i.e. choir, orchestra, etc.) and other honor organizations (i.e. Mu Alpha Theta, Foreign Language Honor Societies, etc.) are not considered extracurricular activities. CLUBS: Amnesty International, Anglers Club, Nat l Art H.S., Architecture Club, Chess Team, Courtyard Club, Déjà Vu, Environmental Rescue, Falcon Ambassadors (note: Ambassadors can also be used for the service category only if service listed is above the yearly requirement), Falcon Athletic Leadership Council, Falcon Sports Network, Falcon Weekly, Flock (note: Flock can be used for the service category or as an extracurricular but not both), Future Doctors of America, Habitat for Humanity, High Schools Against Cancer (HSAC), Hockey, Improv Club, Key Club (note: Key club can be used for the service category or as an extra-curricular but not both), LaCrosse (Boys), LaCrosse (Girls), Math Team, Mock Trial Club, Mosaic, Multicultural Club, Newspaper (Falcon Flyer), O.L.A.S., P.A.W.S., Pep Club, Scholastic Bowl, Science Club, Smash Club, Spanish Club, Student Council (note: Student Council point totals will be evaluated as evidence of adequate involvement), SSMS (Student Support Military Service), True North Stars (SODA), Ultimate Frisbee Club, Yearbook MUSIC: Colorguard, Jazz Bands 1 & 2, Marching Band, Pit Orchestra, Show Choir-Flight PERFORMING ARTS: Fall play, Spring Musical, Speech Team, Technology Club (Stage Crew/Set Design), One Act Plays DANCE: Falconettes Dance Team, Steppers Club GIRLS ATHLETICS: Badminton, Basketball, Cross Country, Cheerleading, Golf, Gymnastics, Soccer, Softball, Swimming, Tennis, Track, Volleyball BOYS ATHLETICS: Baseball, Basketball, Cross Country, Football, Golf, Gymnastics, Soccer, Swimming, Tennis, Track, Volleyball, Wrestling 94. Name of Activity: 95. If you selected "other" above, specify the name of the activity. Keep in mind that only the activities on the list are recognized by the faculty committee as school sponsored extra-curricular activities. 96. Year(s) in which you participated in the activity: 97. Total hours spent in activity per school year: 98. Contributions (i.e. attended meetings/practices, high scorer during game, captain, officer, committee chairperson) 99. Name of adult sponsor/coach: If you are finished entering your extra-curricular activities, skip ahead to page 22.

18 Section 3: School Sponsored Extracurriculars **Extra-Curricular Activities: Finally, in addition to the classroom, Wheaton North believes that much of students character and leadership is demonstrated through their involvement in extra-curricular activities. Therefore, it is the committee s recommendation that: junior students being reviewed for selection will provide evidence that they were a major contributor to at least 4 school sponsored extracurricular activities over the span of their high school years. (for example: football 9, 10, student council 10, yearbook 10 OR soccer 9, 10, 11, newspaper 10) senior students being reviewed for selection will provide evidence that they were a major contributor to at least 5 school sponsored extracurricular activities over the span of their high school years. Being a major contributor means that the student attends regular meetings and/or practices as well as fulfills the activity requirements defined by the coach or sponsor. Below is the list of school sponsored extracurricular activities. Classes at Wheaton North (i.e. choir, orchestra, etc.) and other honor organizations (i.e. Mu Alpha Theta, Foreign Language Honor Societies, etc.) are not considered extracurricular activities. CLUBS: Amnesty International, Anglers Club, Nat l Art H.S., Architecture Club, Chess Team, Courtyard Club, Déjà Vu, Environmental Rescue, Falcon Ambassadors (note: Ambassadors can also be used for the service category only if service listed is above the yearly requirement), Falcon Athletic Leadership Council, Falcon Sports Network, Falcon Weekly, Flock (note: Flock can be used for the service category or as an extracurricular but not both), Future Doctors of America, Habitat for Humanity, High Schools Against Cancer (HSAC), Hockey, Improv Club, Key Club (note: Key club can be used for the service category or as an extra-curricular but not both), LaCrosse (Boys), LaCrosse (Girls), Math Team, Mock Trial Club, Mosaic, Multicultural Club, Newspaper (Falcon Flyer), O.L.A.S., P.A.W.S., Pep Club, Scholastic Bowl, Science Club, Smash Club, Spanish Club, Student Council (note: Student Council point totals will be evaluated as evidence of adequate involvement), SSMS (Student Support Military Service), True North Stars (SODA), Ultimate Frisbee Club, Yearbook MUSIC: Colorguard, Jazz Bands 1 & 2, Marching Band, Pit Orchestra, Show Choir-Flight PERFORMING ARTS: Fall play, Spring Musical, Speech Team, Technology Club (Stage Crew/Set Design), One Act Plays DANCE: Falconettes Dance Team, Steppers Club GIRLS ATHLETICS: Badminton, Basketball, Cross Country, Cheerleading, Golf, Gymnastics, Soccer, Softball, Swimming, Tennis, Track, Volleyball BOYS ATHLETICS: Baseball, Basketball, Cross Country, Football, Golf, Gymnastics, Soccer, Swimming, Tennis, Track, Volleyball, Wrestling 100. Name of Activity: 101. If you selected "other" above, specify the name of the activity. Keep in mind that only the activities on the list are recognized by the faculty committee as school sponsored extra-curricular activities Year(s) in which you participated in the activity: 103. Total hours spent in activity per school year: 104. Contributions (i.e. attended meetings/practices, high scorer during game, captain, officer, committee chairperson) 105. Name of adult sponsor/coach: If you are finished entering your extra-curricular activities, skip ahead to page 22.

19 Section 3: School Sponsored Extracurriculars **Extra-Curricular Activities: Finally, in addition to the classroom, Wheaton North believes that much of students character and leadership is demonstrated through their involvement in extra-curricular activities. Therefore, it is the committee s recommendation that: junior students being reviewed for selection will provide evidence that they were a major contributor to at least 4 school sponsored extracurricular activities over the span of their high school years. (for example: football 9, 10, student council 10, yearbook 10 OR soccer 9, 10, 11, newspaper 10) senior students being reviewed for selection will provide evidence that they were a major contributor to at least 5 school sponsored extracurricular activities over the span of their high school years. Being a major contributor means that the student attends regular meetings and/or practices as well as fulfills the activity requirements defined by the coach or sponsor. Below is the list of school sponsored extracurricular activities. Classes at Wheaton North (i.e. choir, orchestra, etc.) and other honor organizations (i.e. Mu Alpha Theta, Foreign Language Honor Societies, etc.) are not considered extracurricular activities. CLUBS: Amnesty International, Anglers Club, Nat l Art H.S., Architecture Club, Chess Team, Courtyard Club, Déjà Vu, Environmental Rescue, Falcon Ambassadors (note: Ambassadors can also be used for the service category only if service listed is above the yearly requirement), Falcon Athletic Leadership Council, Falcon Sports Network, Falcon Weekly, Flock (note: Flock can be used for the service category or as an extracurricular but not both), Future Doctors of America, Habitat for Humanity, High Schools Against Cancer (HSAC), Hockey, Improv Club, Key Club (note: Key club can be used for the service category or as an extra-curricular but not both), LaCrosse (Boys), LaCrosse (Girls), Math Team, Mock Trial Club, Mosaic, Multicultural Club, Newspaper (Falcon Flyer), O.L.A.S., P.A.W.S., Pep Club, Scholastic Bowl, Science Club, Smash Club, Spanish Club, Student Council (note: Student Council point totals will be evaluated as evidence of adequate involvement), SSMS (Student Support Military Service), True North Stars (SODA), Ultimate Frisbee Club, Yearbook MUSIC: Colorguard, Jazz Bands 1 & 2, Marching Band, Pit Orchestra, Show Choir-Flight PERFORMING ARTS: Fall play, Spring Musical, Speech Team, Technology Club (Stage Crew/Set Design), One Act Plays DANCE: Falconettes Dance Team, Steppers Club GIRLS ATHLETICS: Badminton, Basketball, Cross Country, Cheerleading, Golf, Gymnastics, Soccer, Softball, Swimming, Tennis, Track, Volleyball BOYS ATHLETICS: Baseball, Basketball, Cross Country, Football, Golf, Gymnastics, Soccer, Swimming, Tennis, Track, Volleyball, Wrestling 106. Name of Activity: 107. If you selected "other" above, specify the name of the activity. Keep in mind that only the activities on the list are recognized by the faculty committee as school sponsored extra-curricular activities Year(s) in which you participated in the activity: 109. Total hours spent in activity per school year: 110. Contributions (i.e. attended meetings/practices, high scorer during game, captain, officer, committee chairperson) 111. Name of adult sponsor/coach: If you are finished entering your extra-curricular activities, skip ahead to page 22.

20 Section 3: School Sponsored Extracurriculars **Extra-Curricular Activities: Finally, in addition to the classroom, Wheaton North believes that much of students character and leadership is demonstrated through their involvement in extra-curricular activities. Therefore, it is the committee s recommendation that: junior students being reviewed for selection will provide evidence that they were a major contributor to at least 4 school sponsored extracurricular activities over the span of their high school years. (for example: football 9, 10, student council 10, yearbook 10 OR soccer 9, 10, 11, newspaper 10) senior students being reviewed for selection will provide evidence that they were a major contributor to at least 5 school sponsored extracurricular activities over the span of their high school years. Being a major contributor means that the student attends regular meetings and/or practices as well as fulfills the activity requirements defined by the coach or sponsor. Below is the list of school sponsored extracurricular activities. Classes at Wheaton North (i.e. choir, orchestra, etc.) and other honor organizations (i.e. Mu Alpha Theta, Foreign Language Honor Societies, etc.) are not considered extracurricular activities. CLUBS: Amnesty International, Anglers Club, Nat l Art H.S., Architecture Club, Chess Team, Courtyard Club, Déjà Vu, Environmental Rescue, Falcon Ambassadors (note: Ambassadors can also be used for the service category only if service listed is above the yearly requirement), Falcon Athletic Leadership Council, Falcon Sports Network, Falcon Weekly, Flock (note: Flock can be used for the service category or as an extracurricular but not both), Future Doctors of America, Habitat for Humanity, High Schools Against Cancer (HSAC), Hockey, Improv Club, Key Club (note: Key club can be used for the service category or as an extra-curricular but not both), LaCrosse (Boys), LaCrosse (Girls), Math Team, Mock Trial Club, Mosaic, Multicultural Club, Newspaper (Falcon Flyer), O.L.A.S., P.A.W.S., Pep Club, Scholastic Bowl, Science Club, Smash Club, Spanish Club, Student Council (note: Student Council point totals will be evaluated as evidence of adequate involvement), SSMS (Student Support Military Service), True North Stars (SODA), Ultimate Frisbee Club, Yearbook MUSIC: Colorguard, Jazz Bands 1 & 2, Marching Band, Pit Orchestra, Show Choir-Flight PERFORMING ARTS: Fall play, Spring Musical, Speech Team, Technology Club (Stage Crew/Set Design), One Act Plays DANCE: Falconettes Dance Team, Steppers Club GIRLS ATHLETICS: Badminton, Basketball, Cross Country, Cheerleading, Golf, Gymnastics, Soccer, Softball, Swimming, Tennis, Track, Volleyball BOYS ATHLETICS: Baseball, Basketball, Cross Country, Football, Golf, Gymnastics, Soccer, Swimming, Tennis, Track, Volleyball, Wrestling 112. Name of Activity: 113. If you selected "other" above, specify the name of the activity. Keep in mind that only the activities on the list are recognized by the faculty committee as school sponsored extra-curricular activities Year(s) in which you participated in the activity: 115. Total hours spent in activity per school year: 116. Contributions (i.e. attended meetings/practices, high scorer during game, captain, officer, committee chairperson) 117. Name of adult sponsor/coach: If you are finished entering your extra-curricular activities, skip ahead to page 22.

21 Section 3: School Sponsored Extracurriculars **Extra-Curricular Activities: Finally, in addition to the classroom, Wheaton North believes that much of students character and leadership is demonstrated through their involvement in extra-curricular activities. Therefore, it is the committee s recommendation that: junior students being reviewed for selection will provide evidence that they were a major contributor to at least 4 school sponsored extracurricular activities over the span of their high school years. (for example: football 9, 10, student council 10, yearbook 10 OR soccer 9, 10, 11, newspaper 10) senior students being reviewed for selection will provide evidence that they were a major contributor to at least 5 school sponsored extracurricular activities over the span of their high school years. Being a major contributor means that the student attends regular meetings and/or practices as well as fulfills the activity requirements defined by the coach or sponsor. Below is the list of school sponsored extracurricular activities. Classes at Wheaton North (i.e. choir, orchestra, etc.) and other honor organizations (i.e. Mu Alpha Theta, Foreign Language Honor Societies, etc.) are not considered extracurricular activities. CLUBS: Amnesty International, Anglers Club, Nat l Art H.S., Architecture Club, Chess Team, Courtyard Club, Déjà Vu, Environmental Rescue, Falcon Ambassadors (note: Ambassadors can also be used for the service category only if service listed is above the yearly requirement), Falcon Athletic Leadership Council, Falcon Sports Network, Falcon Weekly, Flock (note: Flock can be used for the service category or as an extracurricular but not both), Future Doctors of America, Habitat for Humanity, High Schools Against Cancer (HSAC), Hockey, Improv Club, Key Club (note: Key club can be used for the service category or as an extra-curricular but not both), LaCrosse (Boys), LaCrosse (Girls), Math Team, Mock Trial Club, Mosaic, Multicultural Club, Newspaper (Falcon Flyer), O.L.A.S., P.A.W.S., Pep Club, Scholastic Bowl, Science Club, Smash Club, Spanish Club, Student Council (note: Student Council point totals will be evaluated as evidence of adequate involvement), SSMS (Student Support Military Service), True North Stars (SODA), Ultimate Frisbee Club, Yearbook MUSIC: Colorguard, Jazz Bands 1 & 2, Marching Band, Pit Orchestra, Show Choir-Flight PERFORMING ARTS: Fall play, Spring Musical, Speech Team, Technology Club (Stage Crew/Set Design), One Act Plays DANCE: Falconettes Dance Team, Steppers Club GIRLS ATHLETICS: Badminton, Basketball, Cross Country, Cheerleading, Golf, Gymnastics, Soccer, Softball, Swimming, Tennis, Track, Volleyball BOYS ATHLETICS: Baseball, Basketball, Cross Country, Football, Golf, Gymnastics, Soccer, Swimming, Tennis, Track, Volleyball, Wrestling 118. Name of Activity: 119. If you selected "other" above, specify the name of the activity. Keep in mind that only the activities on the list are recognized by the faculty committee as school sponsored extra-curricular activities Year(s) in which you participated in the activity: 121. Total hours spent in activity per school year: 122. Contributions (i.e. attended meetings/practices, high scorer during game, captain, officer, committee chairperson) 123. Name of adult sponsor/coach: If you are finished entering your extra-curricular activities, skip ahead to page 22.

22 Section 4: Other Communtity Activities-NOT SERVICE 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. These are not service hours. For example: church groups, clubs sponsored outside the school, Boy or Girl Scouts, or community art endeavors. DO NOT REPEAT PARTICIPATION ALREADY LISTED ABOVE. THIS IS NOT SERVICE Community Activity #1: Community activity: Year(s) 9, 10, 11, 12: Number of hours per school year: Major Accomplishments: Name of Adult Sponsor: Contact Info. for sponsor (phone/ ): 125. Community Activity #2: Community activity: Year(s) 9, 10, 11, 12: Number of hours per school year: Major Accomplishments: Name of Adult Sponsor: Contact Info. for sponsor (phone/ ): 126. Community Activity #3: Community activity: Year(s) 9, 10, 11, 12: Number of hours per school year: Major Accomplishments: Name of Adult Sponsor: Contact Info. for sponsor (phone/ ):

23 127. Community Activity #4: Community activity: Year(s) 9, 10, 11, 12: Number of hours per school year: Major Accomplishments: Name of Adult Sponsor: Contact Info. for sponsor (phone/ ): 128. Community Activity #5: Community activity: Year(s) 9, 10, 11, 12: Number of hours per school year: Major Accomplishments: Name of Adult Sponsor: Contact Info. for sponsor (phone/ ): 129. Community Activity #6: Community activity: Year(s) 9, 10, 11, 12: Number of hours per school year: Major Accomplishments: Name of Adult Sponsor: Contact Info. for sponsor (phone/ ):

24 Section 5: Work Experience List below any job experiences that you have received that support your bid to be selected for membership in the National Honor Society. Work experience is paid. PROVIDE A JOB DESCRIPTION AND INCLUDE THE NUMBER OF HOURS SPENT ON THE JOB Grade 12 job experience including the summer before: Job description: Number of hours spent on Job: 131. Grade 11 job experience including summer before: Job Description: Number of hours spent on job: 132. Grade 10 job experience including summer before: Job description: Number of hours spent on job: 133. Grade 9 job experience including summer before: Job description: Number of hours spent on job: