No applications accepted after
Thursday, March 11, 2021

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National Honors Society 
Application Form

LYONS HIGH CHAPTER OF THE NATIONAL HONOR SOCIETY

STUDENT ACTIVITY INFORMATION FORM

Directions: Please complete all sections electronically. Do not be modest. Every bit of information can be used by the faculty council to assist with the selection process. Completion of this form does not guarantee selection.

I. Administrative Information: This form must be legible to be considered for membership in the National Honor Society. This form must be completed electronically and printed with the necessary signatures obtained before submitting to the LHS office by 3:10 p.m. on the due date. Completion by other methods will nullify the application. This form must be to the LHS office by March 11, 2021, or it will not be considered.

Name: ______________________________

Other information as required:

II. Co-curricular Activities:

List all activities in which you have participated during high school. Include clubs, teams, musical groups, etc., and major accomplishments in each.

Activity

9

Year

10

11

12

Accomplishments

III. 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 for directing or motivating others should be included. For example, elected student body, class, or club officer; committee chairperson; team captain; newspaper editor; work area manager; or community leader.

Leadership Position

9

Year

10

11

12

Activity or Organization

IV. Community Activities: List community activities in which you have participated and note any major accomplishment in each. These should be any activities outside of school in which you participated for the betterment of your community. For example: church groups, clubs sponsored outside the school, Boy or Girl Scouts, volunteer groups, or community art endeavors. Signature or Initials by the adult sponsor is required on the printed copy of the form to be submitted.

Community Activity

9

Year

10

11

12

No. of Hour/Wk.

Major Accomplishment

Signature of Adult Sponsor

V. Work Experience, Recognition, and Awards: List below any job experiences, honors, or recognition that you have received which support your bid to be selected for membership in the National Honor Society. Work experience may be paid or volunteer.

Job, Recognition, or Award

9

Year

10

11

12

Group or Activity/Number of Hours Spent on Job or Volunteer Activity