PLEASE READ THESE GUIDELINES BEFORE COMPLETING YOUR APPLICATION. 1. All applications are due no later than 2:15 pm on May 1, 2019 to Mrs. Jones. They must be handed in personally, not put her mailbox or left in room 309.
2. No changes can be made to your application once submitted and it must be completed in your own handwriting.
3. All application materials must be stapled together and handed in at the same time by the aforementioned due date. Nothing will be accepted late.
4. Please report everything that you have done, even if you are not sure if “it counts�. It is not necessary to fill in all boxes under each category, but ample room was provided so you can include everything, even if you were unsure if it applies.
5. It is important that you try to be as accurate as possible when counting hours of your participation in an activity. Look back at past calendars and try to do the math. Write out the math in the explanation boxes if necessary so we can see how you calculated the number. Do not just arbitrarily guess a number.
6. If you plan on participating in an activity this summer, still check off 11th grade. Summer 2019 counts as 11th grade, 2018 10th grade, 2017 9th grade.
7. For any extracurricular or service activities done in 9th and 10th grade or any leadership positions held in 9th and 10th grade, verifying signatures are not required. Please still explain the activity and list the supervisor name and phone number.
8. For any extracurricular or service activities done in 11th grade, you must have either a verifying signature for Molloy activities (the coordinating moderator must sign off) or an attached letterhead (describing the details and signed by the supervisor) for anything done outside of Molloy. For any leadership position held in 11th grade, only signatures are required; you do not need to attach any letterhead.
9. Mrs. Jones will be available on April 16, 2019 @ 2:10PM in room 309 to answer any questions regarding the application.
ARCHBISHOP MOLLOY HIGH SCHOOL NATIONAL HONOR SOCIETY APPLICATION PACKET Packets are due by 2:15 pm on May 1, 2019. No exceptions!
Name: ____________________________________________________________________ HR _________ ID# _______________ Address: ___________________________________________________________________________________________________ Phone: __________________________________________ Email:____________________________________________________
Part 1.A: Extra-Curricular Activities at Molloy List all activities you have participated in at Molloy. Include clubs, teams, musical groups, and more. This should be something you consistently participated in throughout the year. List the name of the teacher/supervisor who can verify your participation in each activity. Verifying signatures are required for Grade 11.
Activity
9
10
11
Name of Teacher or Supervisor
Verifying Signature (Required if Grade 11 is checked off.) Please sign only if the individual is an active member.
Part 1.B: Extra-Curricular Activities outside of Molloy List all activities in which you have participated in outside of Molloy. Include community or Church groups, teams, and more. List the name and phone number of the supervisor who can verify your participation in each activity. An example has been provided for you.
Activity CYO Basketball
9
10
11
Y
Y
Name of Supervisor and Phone Number Mrs. Jane Smith (555) 555-5555
Detailed Description of Activity and Number of Hours Involved (per week, per month, etc.) *Remember to give as many details as possible.* I practice with the team twice a week. Our games are scheduled for every Sunday from October to March. 6 hours/week for a total of 120 hours/year
Part 2: Leadership Positions Inside and Outside of Molloy Leadership positions will be divided into two areas, elected positions and student leadership. Section A: List all elected or appointed leadership positions you have actively held in school, your community, or work activities. Place a check next to the appropriate year. Include only those positions in which you were directly responsible for directing or motivating others. Some examples include elected spirit leaders, retreat leaders, class or club officers, committee chairperson, team captain, newspaper or yearbook editor, and community leader. Include the name, phone number (only for those outside of Molloy), and signature of an individual who can verify this information.
Position and Brief Description
9
10
11
Supervisor Name and Phone Number
Verifying Signature (Required if Grade 11 is checked off.) Please sign only if the individual is an active member. No letterhead is required for this.
Section B: Many students are leaders in various ways without ever being elected to a leadership position. In this section, we want you to describe how you are a leader in your classroom, school, and/or community. Student leaders are resourceful, good problem solvers, idea contributors, and have a positive attitude about life. Below, list a leadership quality that you possess and then give an example of a time when you demonstrated this quality. Use as many of the spaces below that you desire; you do not need to use each space, but the more information you can provide the better.
Leadership Quality
Example that Demonstrates this Quality
Part 3.A: Community Service at Molloy List all the community service activities you have participated in through our school. Service activities are those that are done for or on the behalf of others for which no compensation (monetary or other) has been given. Not all volunteering is service; you should be directly helping those in need. For example, Peer Tutoring, Briarwood Shelter, LifeSpire, and more. Verifying signatures are required for Grade 11. An example has been provided for you.
Supervisor Name & Signature
Activity
Explanation of Activity Include specific details as well as how many hours per week.
Total Hours Completed to date
Students: Please print the name of your teacher or supervisor for each activity. If your activity was during 11th grade, please ask your teacher/supervisor to sign.
Are You Still Doing This?
Teachers/Supervisors: Please sign only if the student was an active member.
Peer Tutoring
When I was in 10th grade, I tutored a freshman in Algebra. We met twice a week after school in the Peer Tutoring room. Each session was 0.5 hrs. for a total of 1 hour per week. This was from JanuaryJune.
9th Grade: ____0___ 10th Grade: ___20__ 11th Grade: ___30__ Total: ___50_____
When I was in 11th grade, I tutored a new freshman in Algebra. We met once a week after school in the Peer Tutoring room. Each session was 0.5 hrs. This was from October-now. 9th Grade: _______ 10th Grade: ______ 11th Grade: ______ Total: __________
Ms. Dyana Christie *Ms. Christie’s signature would go here since this was an 11th grade activity*
Yes
9th Grade: _______ 10th Grade: ______ 11th Grade: ______ Total: __________
9th Grade: _______ 10th Grade: ______ 11th Grade: ______ Total: __________
9th Grade: _______ 10th Grade: ______ 11th Grade: ______ Total: __________
9th Grade: _______ 10th Grade: ______ 11th Grade: ______ Total: __________
Part 3.B: Community Service/Volunteer Work outside of Molloy List all the community service activities you have participated in that have benefited your local community or neighborhood. Service activities are those which are done for or on the behalf of others for which no compensation (monetary or other) has been given. For example, coaching a CYO team, leading a youth group, and more. For all 11th grade activities, a signed document on letterhead must be attached. Please include in this document: a detailed description of the service activity, what tasks you perform, hours involved, and total hours completed. Be as detailed as possible to give a clear picture of what you do. This document should be signed by the supervisor or coordinator of the activity.
Supervisor Name & Phone Number Activity
CCD Teacher/ Religious Ed Instructor
Explanation of Activity Include specific details as well as how many hours per week.
From September 2018 through this June 2019, I taught/will continue to teach a 2nd grade religious education class every Wednesday from 2:30 to 5PM. I am responsible for teaching the 15 students about Catholicism and preparing them for their First Communion. I created simple lessons and wrote out their report cards.
Total Hours Completed to date
9th Grade: ____0___ 10th Grade: ___0__ 11th Grade: __75_
Students: Make sure a signed document is attached to this application for any 11th grade activities.
Mr. John Smith (555)555-555 *Letterhead is attached.*
Total: ________
This was/is 2.5 hours per week for 30 weeks for a total of 75 hours. I will continue to do this for another 17.5 hours through June. 9th Grade: _______ 10th Grade: ______ 11th Grade: ______ Total: __________
Are You Still Doing This?
Yes
9th Grade: _______ 10th Grade: ______ 11th Grade: ______ Total: __________
9th Grade: _______ 10th Grade: ______ 11th Grade: ______ Total: __________
9th Grade: _______ 10th Grade: ______ 11th Grade: ______ Total: __________
9th Grade: _______ 10th Grade: ______ 11th Grade: ______ Total: __________
Part 5: Faculty Recommendations Applicants are required to obtain signatures of three faculty members supporting and endorsing their application. I endorse and support the application of __________________________ for membership in the Louis E. Willett Chapter of the National Honor Society. 1.______________________________________________________________________________________________
2.______________________________________________________________________________________________
3.______________________________________________________________________________________________
Part 6: Signatures Please read and sign the statement below: I, ______________________, understand that if I accept membership into the National Honor Society, I will be required to attend the Induction Ceremony, attend all meetings (being late counts as an absence), maintain the necessary grade average, complete consistent community service and participate in at least four NHS-sponsored service projects. Student Signature: ___________________________
Date: _____________
Please have a parent/guardian read and sign the statement below: We understand that membership in the National Honor Society is an honor and that membership is based on leadership, community service, scholarship, and character. We also understand that completion and submission of this form only places a student in consideration for membership. The Faculty Council, whose decisions will be confidential, without qualification, and final, will review the form and the recommendations. Parent Signature: _____________________________ Date: _____________