National Honor Society, Xaverian Chapter Candidate Form

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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:__________________________
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National Honor Society, Xaverian Chapter Candidate Form

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