ADELPHIA CHAPTER OF HONOR SOCIETY
All sophomores, juniors and seniors who have a cumulative high school GPA of 3.5 or above
may apply for admission to Honor Society.
Admission is not automatic. In addition to having the required GPA, applicants must
demonstrate significant accomplishment and/or participation in the four areas indicated on the
application form. Each area is weighted equally in the application process, so it is necessary
to have some accomplishments in each area.
All activities, accomplishments, etc. included in the application must have taken place during
high school. Do not include anything that occurred before you were in high school. Doing so
could jeopardize your chances for admission.
Make sure your application is neat and readable.
All applications are read anonymously. Your name will be removed and replaced with a
number. Please avoid indicating your identity anywhere in the application. Anonymity ensures
impartiality and makes the selection process much easier for the committee.
PLEASE NOTE: Honor Society is a service organization. Membership is a highly sought after honor,
but it requires commitment to the ideals of the organization. Your acceptance of membership in
Honor Society will indicate your willingness to participate in all National Honor Society activities such
as meetings and service projects. Your membership in National Honor Society is contingent on your
completion of a year-long project which you will define and keep track of as outlined in the
membership requirements document. Failure to comply with these requirements will result in
dismissal from the National Honor Society.
ALL APPLICATIONS FORMS MUST BE COMPLETED & RETURNED TO
MRS. FOY IN THE COUNSELING OFFICE—BY
2:40 P.M. OCTOBER 4, 2010
ADELPHIA CHAPTER OF THE HONOR SOCIETY
STUDENT ACTIVITY INFORMATION FORM
Please complete all sections. Do not be modest. Every bit of information can be used by the
admissions committee to assist with the selection process. Completion of this form does not
I. General Information (Please type or print):
Year in School (circle one): SO JR SR
Cummulative High School GPA (will be verified): _______________ (25 points)
II. Cocurricular Activities: (25 points)
List all activities in which you have participated during high school. Include clubs, teams, musical groups, etc.,
and major accomplishments in each. Also list any leadership positions you have held relative to that activity.
ACTIVITY 9 10 11 12 ACCOMPLISHMENTS/LEADERSHIP
III. Community Service/volunteerism/work experience (25 pts.)
List community activities in which you have participated and note any major accomplishment or leadership positions held 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. An example of a major accomplishment would
be the attainment of Eagle Scout within the scouting organization. An example of leadership might be a promotion to team leader or supervisor in
PLEASE NOTE: DO NOT LIST THE ACTIVITIES ASSOCIATED WITH YOUR REQUIRED JUNIOR YEAR SERVICE HOURS. List only
the activities that have been done above and beyond the requirement for all students during their junior year.
9 10 11 12 NUMBER OF LEADERSHIP POSITIONS NAME & CONTACT INFORMATION
COMMUNITY ACTIVITY HOURS HELD/MAJOR FOR ADULT SPONSOR*
PER WEEK ACCOMPLISHMENTS
* Please include complete contact information so that we can verify your participation in the above activities if necessary. Without this information,
the activity listed will not be considered.
IV. Personal Statement: (25 pts.)
The last section of your application is a personal statement of no more than 150 words. Please attach your
typed personal statement to this application. Use your personal statement as an opportunity to express your core
values and beliefs and explain how those values support your academic success and service to others.
I UNDERSTAND THAT IF I AM ACCEPTED INTO THE ADELPHIA CHAPTER OF HONOR SOCIETY I WILL BE
EXPECTED TO ATTEND GROUP MEETINGS, PARTICIPATE ACTIVELY IN GROUP SERVICE PROJECTS, AND WILL
BE EXPECTED TO WRITE AND PRESENT A PLAN FOR MY SERVICE PROJECT AND DEMONSTRATE THAT I
COMPLETED THE PROJECT AT THE END OF THE SCHOOL YEAR.
PARENT REVIEW AND CONSENT: I have reviewed my son/daughter’s application and
affirm that it is correct. I give my consent for my son/daughter to apply for membership in the
Adelphia Chapter of the National Honor Society.