Stuttgart Chapter
of the National Honor Society
Candidate Form
The purpose of this chapter shall be to create an enthusiasm for scholarship, to
stimulate a desire to render service, to promote worthy leadership, and to
encourage the development of character in students of Stuttgart High School.
Directions:
Read through the entire form. Complete all sections carefully. This form must be typed.
Return to the NHS Faculty Advisor in person. Do not give this form to another person to submit
for you as information may require clarification before being presented to the Faculty Council.
Although outstanding academic achievement is a basic requirement of NHS membership, your
involvement in school and community activities will be significant factors in the evaluation of
your Candidate Form. We are looking for an overall portrayal of your character and
achievements, not just your GPA.
Please provide whatever information you can to assist with the selection process, but do not list a
single activity, position, or experience in more than one of the categories below. Do not be
modest, but do be completely honest.
Completion of this form does not guarantee selection.
You may peruse the associated Candidate Form Rubric to ascertain the specific criteria by which
your application will be assessed.
You will be contacted when the selection process is completed. Submitting the Candidate Form
is only the beginning of the application process. Faculty evaluations of all candidates are
solicited, and then the Faculty Council makes the final decision. Please be patient as this process
takes about two months.
NHS Candidate Form Rubric
Student Name: ____________________________
Grade: __________
GPA: __________
________ Leadership Experience (0-5)
________ School Sponsored Activities (0-5)
________ Community Service Activities (0-5)
________ Work Experience (0-5)
________ Recognitions and Awards (0-5)
________ Essay (0-10) (typed, error-free, organized and clear, 350 words minimum, not boastful)
________ Transcripts Included (Y/N)
________ Current Schedule Reflects Academic Rigor (0-5)
________ Signed and Dated by Parent and Student (Y/N)
________ Application Is Neat, Complete, and Typed (0-5)
________ Total Points (out of 45)
Faculty Evaluations: Good Standing ______
Question(s)
______
Problem(s)
______
Questions or Concerns:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
I. Administrative Information
Student Name: __________________________________________
Grade: __________
If you have not attended Stuttgart or Patch High School since the beginning of your ninth
grade year, list other high schools (and city, state) you have attended and the years you
attended those schools.
School
City
State
Years Attended
Your cumulative high school grade point average (GPA): ____________ [The registrar
will verify GPA. The minimum requirement is 3.5. Your cumulative high school GPA
includes all high school courses. GPA is based on semester (permanent) grades.]
II. Leadership Positions: List all elected or appointed leadership positions held in school,
community, or work activities. Include only those positions in which you were directly
responsible for directing or motivating others. (For example, elected student council, class, or
club officer; committee chairperson; team captain; newspaper editor; work area manager; or
community leader.)
Leadership Position
Activity or
Organization
9
10
11
12
Supervisor Signature
Supervising Adult
III. School Sponsored Activities: List school sponsored extra-curricular activities in which you
have participated. These would include any performance groups, sports teams, or clubs.
Please list the supervising adult who can verify your participation in each activity.
School Sponsored Activity
9
10
11
12
Supervisor Signature
Print Supervisor’s Name
IV. Community Service Activities: List community service activities in which you have
participated. These should include only individual or group projects that were done outside
of school (with, for example, a church group or Girl/Boy Scouts). Generally speaking,
service activities are those that are done on behalf of others (not including immediate family
members) and performed without compensation or reward. Please list the name of an adult
supervisor who can verify your participation in each activity.
Community Activity
9
10
11
12
Number of
Total Hours
Supervisor Signature
Supervising Adult
Community Activity cont.
9
10
11
12
Number of
Total Hours
Supervisor Signature
Supervising Adult
V. Work Experience: List any paid work experience. Please list the name of an adult
supervisor who can verify your experience.
Position Held
9
10
11
12
Hours per Week
Employer/Supervisor
VI. Recognition and Awards: List any honors, awards, or recognitions that you have received
which support your bid to be selected for membership in the National Honor Society. Do not
include honor roll as this does not distinguish any candidate.
Recognition or Award
9
10
11
12
Organization Giving the Award
VII. Essay: Explain why you think you should be selected for National Honor Society and what
you think you will contribute to Stuttgart’s Chapter. Attach as a separate sheet, typed
and double-spaced. 350 word minimum.
VIII. Transcripts: A copy of your official transcripts must be included with your Candidate
Form.
VIII. Current Schedule:
Class
Teacher
Room No.
Period 1
Period 2
Period 3
Period 4
Period 5
Period 6
Period 7
Period 8
I understand that completing the Candidate Form does not guarantee selection to NHS,
and that the information presented here is accurate.
______________________________________
Student Signature
___________________________________
Date
I have read the information provided by my son or daughter on this form and can verify that it is
true, accurate, and complete in its presentation.
______________________________________
Parent Signature
____________________________________
Date