NJHS APPLICATION South Charlotte Middle School DUE: APRIL 15, 2016
SOUTH CHARLOTTE MIDDLE SCHOOL CHAPTER OF THE NATIONAL JUNIOR HONOR SOCIETY STUDENT APPLICATION FORM For consideration, the student must have a minimum 3.5 G.P.A. for each quarter in sixth grade and for the first three quarters in seventh grade. Before completing this application, the candidate must have Mrs. Felder verify that he/she meets the grade requirement. Please bring this page to Mrs. Felder (registrar), so she complete this section FIRST. Student Name: G.P.A. Requirement Met (Yes/No): Signature of Registrar: Directions: Please complete all sections. (Please type or print neatly in BLACK ink.) Do NOT be modest. All information will be helpful in assisting with the selection process. Completion of this form does not guarantee selection. Be sure to turn in your complete application to Mrs. Yasurek (Room 312) by April 15, 2016. Activities may be listed only once on the application. I. Personal Information Student s Name: Homeroom: Parent Name: Telephone: Required Signatures I understand that completing this form does not guarantee selection to NJHS, and that the information presented here is complete and accurate. Student Signature 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 This student has shown good behavior (NO ISS or OSS during the sixth and seventh grade school years). Administrator s Signature (Applicant must obtain)
II. Co-curricular Activities: List all activities in which you have participated since sixth grade. Include clubs, teams, musical groups, etc., and major accomplishments in each. 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, leadership positions include: elected student body, class, or club officer; committee chairperson; team captain; newspaper editor; work area manager; or community leader.
IV. Service Activities: List service activities in which you have participated. These can be service projects done with a group in or out of school, or done as individual projects performing service. Generally speaking, service activities are those that 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. SIGNATURE OF ADULT SUPERVISOR V. Other Community Activities: List 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, community activities include: religious groups, clubs sponsored outside of school, Boy or Girl Scouts, or community art endeavors. Do not repeat participation already listed above. COMMUNITY HOURS / WEEK MAJOR SIGNATURE OF ADULT
VI. Work Experience, Recognition, and Awards: List below any job experiences, honors, or recognition you have received that support your bid to be selected for membership in the National Junior Honor Society. Work experience may be paid or volunteer. JOB RECOGNITION OR AWARD GROUP OR NAME AND NUMBER OF HOURS SPENT ON JOB OR VII. Essay: Please type an essay about the following topic, and attach it to the student application form. The National Junior Honor Society establishes rules for membership based upon the areas of scholarship, service, leadership, character, and citizenship. Please write an essay about the importance of these qualities in the life of a teenager in the 21 st century. Rubric for Selection: (To be selected, you must obtain a minimum of 30 points.) Maximum Co-curriculum Activities Leadership Positions Service Activities Community Activities Work Experience and Awards Essay Total Possible Points: 10 points 3