Name: _______________ (**Last Name First**) Student ID # __________
2015 — 2016 School Year Membership Application
The purpose of the SNHS is
“… to encourage participation in and recognition of scientific and intellectual thought,
to advance students’ knowledge of classical and modern science, to communicate
with the scientific community, to aid the civic community with its comprehension of
science, and to encourage students to participate in community service and, in turn,
encourage a dedication to the pursuit of scientific knowledge.”
Churchill juniors and seniors interested in joining the SNHS and who meet the
requirements laid out below are invited to submit an application for membership.
Applications are to be received no later than close of business April 27, 2015. Completed
applications may be left with Mr. Nugent in room 201A, in room 249 during lunch on Mon
and Thu or 201A on Tue and Wed, or dropped off in the main office to be placed in his
mailbox.
If you have any questions or comments, contact the SNHS faculty advisor, Mr. Nugent.
Membership Responsibilities

Tutor during lunch at least twice per semester.

Attend one scheduled SNHS lunch lecture per semester.

Attend all mandatory SNHS meetings.

Have taken one AP science course or AP equivalent course (Molecular Genetics
or Anatomy and Physiology) no later than your senior year, take a science course
for all four years of attendance at Churchill, and maintain an overall GPA of 3.50
and a science GPA of 3.75.

Participate in SNHS fund raising activities.

All members are to have an active email account in Edline, i.e. you can receive
email through Edline.

For seniors: Be members in good standing at the end of your junior year.
To Apply for Membership
To apply for SNHS membership, you must:

Currently have and maintain an overall un-weighted GPA of 3.50 or higher and an
overall un-weighted GPA of 3.75 or higher in science classes. A general rule of
thumb for science classes is that at a minimum you must have three A’s for every
B. If you have questions about your GPA contact one of the SNHS officers.

For Seniors only: If you were a member as a junior and dropped from
membership for non-academic reasons, you are not allowed to apply for
membership renewal as a senior. Sign here to indicate your junior membership
was in good standing at the end of your junior year:
Signed: _________________________________________

Pay the annual membership dues ($15.00) each year. Membership fees will be
collected online through the Churchill online pay site found at
Churchill Online Payments
which can also be reached via the Churchill school home page by scrolling down
and looking to the left to find the hyperlink for “Online School Payments System.”
If for some reason you are not able to obtain a credit card to make a payment
through the online system contact Mr. Nugent directly before the membership drive
deadline to arrange an alternative means of payment.
Please contact Mr. Nugent if there are any financial difficulties concerning paying
for membership. No one will be denied membership based on an inability to
pay dues.
I have submitted payment via online___________________________ (signature)
Note: Fees paid for dues or anything for which fees are collected are nonrefundable.


Attach a short, typed essay telling us why you are interested in science. You can
focus on a specific aspect or subject in science or write about science in general.
For incoming Juniors or new members who are seniors: Attach a copy of your
most recent Student Grades and Graduation Credit Report, which can be found on
Edline under “Private Reports”; do not provide a copy of an alternate document,
e.g. a report card. Do not go to the registrar and obtain your unofficial transcript
from Ms. Fabrizo as she will not provide you one for this purpose. This is to be the
last page of your application packet.
Note: 1. If your application packet is incomplete, missing anything, or done
incorrectly, e.g. your name is written in incorrectly on this app, it will not be
accepted; this is non-negotiable.
2. No applications will be accepted past the deadline date given in this form.
Application Questions:
1. Have you completed an AP science course? Y/N
2. If yes to question #1, which course did you take? ___________________________
3. If you answered no to question #1 and are going to be a senior this coming school
year, what AP science course have you signed up for in the current school year?
4. If you answered no to question #1 and are going to be a junior this coming school year,
indicate below with your signature that you understand that you are required to take an
AP science course in your senior year if you are to maintain membership in the SNHS.
Signed ________________________________________
5. Do you have an active email account in Edline? Yes/No
I understand that not meeting any of the membership responsibilities outlined above or
the requirements listed in the SNHS by-laws can result in dismissal from the Society.
You will be notified by email if you’ve been accepted into the SNHS. If your application
was not accepted you will be notified as well.
Name (please print)
Signature
Date
Parent Signature
For parents: If you are a science professional, or have a career in a profession that
may not be directly scientific but related to science (a lawyer doing patent law, an IT
specialist, a business person for a company focused on science or engineering, etc.)
we are looking for lunch time lecturers for the SNHS membership and if you’d be
interested in presenting to our students we’d greatly appreciate your signing below
and providing contact information – the SNHS faculty advisor will be in touch with you
in late Aug/early Sep of the 2015 – 2016 school year.
Signature: ___________________________________________________
Contact Information: ___________________________________________