student activity information sheet - Oconomowoc Area School District

OCONOMOWOC HIGH SCHOOL CHAPTEROF THE NATIONAL HONOR SOCIETYSTUDENT ACTIVITY INFORMATION SHEETDirections: Please complete all sections. If completing by hand, please type or print neatly in BLACKink. If completing this form on the computer, ARROW or LEFT MOUSE CLICK to the line/spacewhere you want to input a response. Your name should be centered on the “student’s name” line. Todo so, insert your cursor at the front of “Student’s” and hit the “end” key. (Page breaks have beeninserted to preserve the integrity of the original form. Please do not exceed the space before thebreak. To view the page breaks, turn on your view button.) Please do not print this form back toback. Do not be modest. All information will be helpful in assisting with the selection process.Completion of this form does not guarantee selection. Activities may be listed only once on theapplication. Please return the completed form to Mrs. Myhre (room 160) or Mrs. Wilcox (room 164)by Monday, October 10 th . Late applications will not be accepted.Administrative InformationStudent’s Name:Candidate Number(For Administrative Purposes Only)Other information as requiredI understand that completing this form does not guarantee selection to NHS, and that the information presentedhere is accurate.Student SignatureDateI have read the information provided by my son/daughter on this form and can verify that itis true, accurate and complete in its presentation.Parent SignatureDate

STUDENT ACTIVITY INFORMATION SHEETCanditate Number(For Administrative Purposes Only.)I. Cocurricular Activities - List all activities in which you have participated during high school.Include clubs, teams, musical groups, etc., and major accomplishments in each.Activity Year Accomplishments9 10 11 12II. 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 fordirecting or motivating others should be included. For example, elected student body, class, or clubofficer; committee chairperson; team captain; newspaper editor; work area manager; or communityleader.Activity Year Accomplishments9 10 11 12

III. Service Activities - List service activities in which you have participated. These can beservice projects done with a group either in or out of school, or done as individual projectsperforming service. Generally speaking, service activities are those which are done for or on behalfof others, (not including immediate family members), for which no compensation, (monetary orother), has been given. Please list the name of an adult supervisor who can verify your participationin each activity.Activity Year Adult Sponsor9 10 11 12IV. Other Community Activities - List other community activities in which you haveparticipated and note any major accomplishments in each. These should be any activities outside ofschool in which you participated for the betterment of your community. For example: churchgroups, clubs sponsored outside the school, Boy or Girl Scouts, or community art endeavors. Do notrepeat participation already listed above.CommunityActivityYearHours/WeekMajorAccomplishmentsSignature ofAdult Sponsor9 10 11 12

V. Work Experience, Recognition, and Awards - List below any job experiences, honors, orrecognition that you have received that support your bid to be selected for membership in theNational Honor Society. Work experience may be paid or volunteer.Job, Recognition, or AwardYear9 10 11 12Group or Activity/Number ofHours Spent on Job or VolunteerActivity

Personal StatementMaintaining your complete anonymity, Write a personal statement in 250 words or lessexplaining, “How your character, leadership, service, and scholarship will contribute to theNational Honor Society organization.” Please highlight any and all volunteer experience.