National Honor Society, Xaverian Chapter Candidate Form

National Honor Society, Xaverian ChapterCandidate FormName:_______________________________________________________________Student ID #: _____________________Community #: ________________________ Current Grade Level: 11 12Helpful hint: Do not be modest. Your application provides you the opportunity to sell yourself to the Faculty Council who will fairlyevaluate your qualifications for membership. Proudly make a case for yourself – focus on quality instead of quantity. If an activityfits into more than one category, select the best fit. You cannot repeat any activity in more than one category. Complete eachsection with care, adding more space to the Candidate Form where needed.1. Leadership ExperiencesList, in order of importance, all leadership experiences held in school, community, or work activities during your time at Good Counsel.Emphasize those positions in which you were responsible for directing or motivating others. Include any experiences in which youdemonstrated characteristics of an effective leader. You should only include activities in which you are able to clearly explain howyou positively contributed to a team, club, organization or work environment. Examples: leader of an organized activity or function,elected officer for student government, club chairperson, newspaper editor, work manager, etc...List LeadershipExperiencesYear(s)(9-12Only)Explain How Youbecame a memberand/or Attained theSpecific LeadershipPositionDescribe Your Dutiesand/or ResponsibilitiesExplain How You Contributedin a Leadership Manner

2. Service ActivitiesList, in order of importance, service activities in which you have participated during your time at Good Counsel. Service is defined asvolunteer work with no monetary compensation OR school credit. Please list the name and phone number of an adult supervisor who can validate your service, and list thenumber of hours you invested while performing this service.ActivityNumber of HoursCompleted(above GCrequirement)Explain Your Responsibilities and ContributionsName AND ContactInformation ofAdult Sponsor3. Recognition and AwardsThough not a specific criterion for membership, please list below any recognition or awards that you have received during your timeat Good Counsel that support your candidacy for membership in the Honor Society.Academic Recognition and/or AwardsYear Given(9-12 only)

4. SignaturesI am aware that only the service, activities and honors documented in this application will be considered by the Faculty Committee.I understand that the completion of this form does not guarantee selection into the National Honor Society. If selected, I agree to acceptthe responsibilities of membership as listed below:1. I will participate in the formal induction ceremony on (date to be determined).2. I will complete 7 hours of service (above the required school service hours) to Good Counsel each year of membershipthrough peer tutoring, assisting teachers in their classrooms and/or participating in NHS service-related projects.3. I will maintain a 3.5 GPA each year of membership.4. I will attend scheduled NHS meetings of the National Honor Society and check my Good Counsel e-mail on a regular basis.5. I will adhere to Good Counsel’s code of conduct and be a role model for my peers.I understand that my membership may be revoked if I do not meet the above obligations.I attest that the information presented in this application is complete, accurate, and is my own work.Student signature: _________________________________________________________ Date: ________________________I have read the information provided by my son/daughter on this application and can verify that it is true, accurate, and complete.Parent/Guardian Signature: _________________________________________________ Date:__________________________

National Honor Society, Xaverian ChapterCharacter Reference FormNOTE: This letter may not be written by afamily member or a GC Faculty member.Thank you for assisting in the NHS membership process for __________________________________. NHS membership requiresleadership and character which can be difficult to evaluate. Listed below are some helpful examples of what NHS students areexpected to exhibit in terms of character and leadership:Attributes a student of character may possess:• Takes criticism willingly, accepts recommendations graciously, is punctual when called upon• Possesses the Xaverian Values of simplicity, humility, compassion, zeal and trust• Demonstrates the highest standards of honesty and integrity• Manifests truthfulness in acknowledging obedience to rulesAttributes a leader may possess:• Takes the initiative in activities and strives to train and aid others to attain common objectives• Willingness to yield one’s personal interests for the interest of others• Self-confidence and the ability to go forward when others hesitatePlease attach a letter of reference recommending the above student for membership into NHS based on his/her character andleadership attributes. Character references that include specific anecdotal examples of how the student has demonstrated theabove criteria, while in high school, will be given the highest consideration.Reference letters must be received no later than noon on Friday August 31, 2012.Sincerely,Amy Land (land@olgchs.org)Leslie Young (young@olgchs.org)NHS Chapter AdvisorsNational Honor Society, Xavarian ChapterPlease sign, seal and return your letter of reference to:Our Lady of Good Counsel High SchoolAttn: Amy Land17301 Old Vic BlvdOlney, MD 20832

National Honor Society, Xaverian ChapterCandidate Essay FormPlease respond to the following questions in one typed page (standard font and margins.)DO NOT INCLUDE YOUR NAME ON THE ESSAY – INSTEAD LIST YOUR STUDENT ID NUMBER IN THE HEADER.It is essential that your student ID number be listed; otherwise it is impossible for the Faculty Council to match your profile and youressay. Without either portion the profile is considered incomplete and will not be reviewed. When submitted, there will be aseparate box for Candidate Forms and Candidate Essays.“The Xaverian Chapter of the National Honor Society emphasizes leadership and service. Citing atleast one anecdotal example, how have you demonstrated the Xaverian Values through leadershipand/or service? What impact will your membership in NHS have on the Good Counsel community?”Checklisto Candidate Form: completed and signed by you and a parento Candidate Essay: Typed, no more than one page with student ID inthe header, NOT your name.o Character Reference Form: Please ensure that your reference letteris received by no later than Friday, August 31, 2012.o Willingness to complete additional service hours to school: Pleasebe aware that this is a requirement once accepted into NHS.**Submit ALL components by NOON on 8/31/12**