Oakmont National Honor Society
Student Information Sheet

Directions: Please complete all the sections. (Type or print).
This is your opportunity to let the NHS Faculty Council know
about your activities, leadership, and service in school and in
the community. Do not be modest. Every bit of information
will be used by the Faculty Council to assist with the selection
process. Do not list your activities in more than one category.
Completion of this form does not guarantee selection into
NHS; it indicates to the Council that you wish to pursue the
process. If you need more room, please type a separate sheet.

Part I: Administrative Information

Name: __________________________________________

Address: ________________________________________

Town: ___________________________ Zip: ___________

Homeroom #: ____________

Part II: School Activities
List all the activities in which you have participated in high school. Include clubs, teams, musical groups, etc. Note the leadership positions you held in the group. Indicate any community service you provided through that group. Indicate any major accomplishments you helped the group achieve.

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Activity	Grades Involved	Leadership Roles/ Accomplishments/Community Service
	(9, 10, 11, 12)
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
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Part III: Out of School Activities
List activities in which you have participated that are NOT a part of a school activity. They can be individual or group activities outside of school and should be activities for which you have received no compensation. Include any community service which was done for or on behalf of others, but was not a part of an Oakmont club or group. Include the name of an adult supervisor who can verify your participation in each activity.

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Activity	Grades Involved	Time Commitment (Hours)	Adult Sponsor
	(9, 10, 11, 12)	(Weekly? Monthly? One-time?)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________

 

Part IV: Recognitions, Awards, and Work Experience
List any job experiences, honors, and/or recognitions that you have received recognize your scholarship, character, leadership, or service. Work experiences may be paid or volunteer.

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Recognition/Awards/Work	Grades (9, 10, 11, 12)	Group or Activity	Time Commitment
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________

Part V: Special Notes. Is there any other information you wish to share that has not been covered in the sections above? Add that information for the Faculty Council.

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

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I understand that completing this form does not guarantee selection to NHS. I acknowledge my responsibility to provide true and accurate information to the NHS Faculty Council.

Student Signature: _______________________________________________Date:_________________

I have read the information provided by my son/daughter on this form, as well as the handouts s/he has received. I can verify that it is true, accurate and complete in its presentation.

Parent Signature: ________________________________________________Date:_________________