STUDENT ACTIVITY INFORMATION FORM
Directions: Please complete all sections. Do not be modest.
Every bit of information can be used by the faculty committee to assist
with the selection process. Completion of this form does not guarantee
selection.
Name___________________
Co-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 |
9th |
10th |
11th |
12th |
Accomplishments |
Sponsor Signature |
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Community Service
List any service projects you have participated in. These
should be any activities outside of school in which you participated for
the betterment of your community. You need a minimum of 10 hours of service
to be eligible for membership in NHS. Be sure to get a signature
from the sponsor of your service project.
| Community Service |
9th |
10th |
11th |
12th |
Hours |
Sponsor Signature |
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Leadership
List all elected or appointed leadership positions held in school,
community, or work activities and other areas where you have shown leadership
skills.
| Leadership |
9th |
10th |
11th |
12th |
Activity |
Sponsor Signature |
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On a separate piece of paper, list any other ways that you feel you
have demonstrated leadership. The NHS National Constitution states
that a 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; 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, and in other
school or community activities; is thoroughly dependable in any responsibility
accepted; and is willing to uphold scholarship and maintain a loyal school
attitude.