National Junior Honor Society (NJHS)
Application Packet Cover Page
***This Application Packet is due no later than Monday, November 23rd ***
(Hand in to Mrs. Maxey in Portable 10)
Please assemble your packet in the following order. Make sure your name is on every page.
□ Application Packet Cover Page
□ Student Activity Information Sheet
□ Teacher Recommendation Form
□ Essay
I understand that completion of this packet does not guarantee selection into the
National Junior Honor Society and I verify that all information presented is both
accurate and complete.
______________________________
Student Name (first & last; please print)
______________________________
Student Signature
_______
Grade
________________
Date
Name of Candidate:___________________________
Grade:_______
National Junior Honor Society
Student Activity Information Sheet
Directions:
• Please complete all sections of this sheet
• Please print clearly or type (you can download this form off the RHMS website if
you would like to type your answers)
• Try to fill in as much as possible (fill up the blocks if you can)
• If you have more items than space provided, please list only the most important
and place items in the correct location.
1. Scholarship
List all honors and awards earned for academic excellence in the last two years. (You may include
honor roll, straight A’s, and your GPA.) Include how many above grade level and/or honor courses
you have taken in the last two years.
Honor or Award
Date
Ex. Earned all’s A’s
1st quarter of 6th grade
2. Co-Curricular Activities
List all in-school and community activities in which you have participated in the past two years.
Include clubs, teams, musical groups, major accomplishments, etc.
Activity
Accomplishments
Year
Ex. Recycling Club
Made posters & collected recycling
6th Grade
weekly
Name of Candidate:___________________________
Grade:_______
3. Leadership
List all leadership experience you have had at school or in the community in the last two years.
Include positions in which you were responsible for directing or motivating others. (Ex: elected
position of the SGA, club officer, scouting, youth group, team captain, etc.)
Leadership Role
Accomplishments
Year
Ex. SGA Class Representative
Raised $200 for Pennies for Patients
5th Grade
4. Service
List all service activities in which you have participated in the last two years. These can be service
projects with a group in or out of school or done as an individual. Generally, these are done for or on
the behalf of others (not including immediate family) for no compensation (payment). Please include
the name of an adult who can verify your service activities.
Service Activity, Organization,
Dates/# of
Contact Person
and Location
hours
Ex. Collected and distributed coats
November, 5
Joe Smith
at Agape Homeless Shelter, Silver
hours;
Spring
December 5
hours
Name of Candidate: _______________________________
Grade: ________
National Junior Honor Society
Teacher Recommendation Form
This student is eligible for membership in the National Junior Honor Society (NJHS). Students must
obtain four signatures from either current or last year’s teachers. Students, please be considerate by
requesting recommendations at a convenient time.
Selection for membership is based on outstanding scholarship (3.85 cumulative GPA), citizenship,
character, leadership, and service. Once selected, members have the responsibility to continue to
demonstrate these qualities.
If you would recommend the candidate, according to the above stated qualifications- without
reservation, please sign in the space below.
1. I recommend this candidate, without reservation, for membership in the NJHS.
__________________________________________________
Teacher Signature
Print Name
__________________________________________________
Subject Taught
2. I recommend this candidate, without reservation, for membership in the NJHS.
__________________________________________________
Teacher Signature
Print Name
__________________________________________________
Subject Taught
3. I recommend this candidate, without reservation, for membership in the NJHS.
__________________________________________________
Teacher Signature
Print Name
__________________________________________________
Subject Taught
4. I recommend this candidate, without reservation, for membership in the NJHS.
__________________________________________________
Teacher Signature
Print Name
__________________________________________________
Subject Taught
National Junior Honor Society
Essay Question
In your middle school career, you have demonstrated excellence in scholarship
reflected by your grade point average. The National Junior Honor Society extends
beyond grades and seeks individuals who demonstrate leadership qualities which
positively impact their community. If you are selected to be a member, you will be
expected to participate and/or lead service learning activities. In essay form, explain
your plan for initiating a service learning activity which will positively impact your
community.
Your plan should include:
a) the target audience for the activity
b) the necessary steps needed for this activity to be successful
c) how YOU would demonstrate leadership for the activity
Guidelines:
 Essay format
 Please type your essay, double-spaced, in 14 point font.
 Please keep your essay to approximately 1 to 2 pages double spaced
 Proofread- use proper grammar, punctuation, capitalization, and spelling.
Character is who you are when no one is looking.
Citizenship is your commitment to your school, neighborhood, city, state, nation, and world.