Andersen Middle School Chapter

National Junior Honor Society

Congratulations FUTURE NJHS Student!

You have earned a cumulative grade point average of 3.5 or higher for the first semester! You
are invited to apply for membership in the Andersen Middle School Chapter of the National
Junior Honor Society. The National Junior Honor Society (NJHS) is the nation's premier
organization established to recognize outstanding middle level students. More than just an
honor roll, NJHS serves to honor those students who have demonstrated excellence in the areas
of scholarship, service, leadership, character, and citizenship. These characteristics have
been associated with membership in the organization since its beginning in 1929.

This invitation to membership is dependent upon your timely completion of the information
contained in your Application Packet, recommendations (solicited and unsolicited) and review
by the Andersen Middle School NJHS Faculty Council.

Please use the checklist on the following page as a guide to complete the Candidate
Application Packet and turn it in to Mr. Palaganas by Thursday, February 24, 2022.

Again, congratulations on your scholastic achievement! I look forward to receiving your

application for membership to NJHS.

Sincerely,

Mr. Brian F. Palaganas

NJHS Faculty Adviser
 Andersen Middle School Chapter of the National Junior Honor
Membership Application Packet

€ Write a short essay explaining why you feel you deserve to be selected for membership in
the NJHS.

€ Resume

€ Complete the Student Activity Information Form which includes

1) At least one (1) leadership Position which must be during the current or spring
semester of the previous year.
2) At least one (1) community service in the current year with a minimum of 10
hours per semester. Summer and winter break will be counted toward the semester
total. Anything for which you receive no compensation (water stops for
fundraisers, Trash-a thon, etc.) may be considered.
3) Two (2) co-curricular activities with sponsor recommendation, one having to
be in the current school year.
4) Other achievement(s).
5) Five (5) teacher recommendations from the current school year.

Please Note
1) You must have all the required signatures or the form will not be considered.
2) All recommendations turned in by students must be in a sealed envelope.
3) You may submit additional recommendation forms.
4) You must submit all required forms in a timely manner.
5) Recommendations can only be used for one area – organization or community
service, not the same group for both.
6) Sponsor means adult advisor not student officer.
7) Make sure the recommendations are turned in on the correct form.
8) Students should fill in the deadline date and who should receive the completed forms,
before submitting them to the teachers/advisors.
9) The top of the form should be filled in by the student – don’t expect the evaluator to
complete it.
10) All packet information is due on or before 11:59pm - Thursday, February 24, 2022
(online via your student gmail). They may be dropped off in person earlier in Mr.
Palaganas Rm. 109 - AMS
 Student Activity Information Form
DIRECTIONS: Please complete all sections. 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.

Name:___________________________________________________ Grade: ________

I. Leadership Positions

List all elected or appointed leadership positions held in school, community, or work activities.
Only positions in which you were directly responsible for directing or motivating others should
be included, such as elected student body, class, or club officer; committee chairperson; team
captain or co-captain; newspaper editor, or work area manager.

Be sure to include at least one (1) leadership position, which has been during the current school
year or spring semester of the previous year.

Leadership Position School Year Activity/Organization Sponsor’s signature & Tel #

II. Community Service 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, Boy or Girl
Scouts, volunteer groups, or community arts endeavors.

At least one (1) community service must be in the current year with a minimum of 10 hours per
semester. Summer and winter break will be counted toward the semester total. Anything for
which you receive no compensation (water stops for fundraisers, Trash-a thon, etc.) may be
considered.

Community Service School Year Total Hours Major Accomplishments Sponsor’s Signature & Tel #
III Co-curricular Activities List any other activities not already listed in which you have
participated during middle school. Include clubs, teams, musical groups, etc., and major
accomplishments in each. For example: Robotics Team, Drill/Flag Squad NJROTC, Culture
Club, Reading Pals, Class Ambassador, Math Counts, Advanced Band.

School
Activity Accomplishments Sponsor’s signature and Tel #
Year

IV Other Achievement(s): List any other activities and/or achievements that did not fit into the
categories above but that you feel are noteworthy.

School
Achievement/ Accomplishments Sponsor’s signature and Tel #
Year
 National Junior Honor Society (NJHS) Candidate Evaluation

--- Organizations ---

________________________________________________________________ Grade _______

Name of Student

________________________________________ ___________________________________
Name of Organization Name of Sponsor/Organization Adult Supervisor

_____________________________ ________________
Number of Hours Participated/Worked Year(s) Involved

Service, leadership, character, and citizenship are among the pillars of membership in the
National Junior Honor Society. Organization Sponsors are asked to comment and/or
recommend this student for membership in the Andersen Middle School Chapter of the
NJHS.

Comments:

Signature:___________________________ Phone:_________________
 AMS National Junior Honor Society (NJHS) Candidate Evaluation

--- Organizations ---

________________________________________________________________ Grade _______

Name of Student

________________________________________ ___________________________________
Name of Organization Name of Sponsor/Organization Adult Supervisor

_____________________________ ________________
Number of Hours Participated/Worked Year(s) Involved

Service, leadership, character, and citizenship are among the pillars of membership in the
National Junior Honor Society. Organization Sponsors are asked to make comments
and/or recommend this student for membership in the Andersen Middle School Chapter of
the NJHS.

Comments:

Signature:___________________________ Phone:_________________

Andersen Middle School

Chapter of the National Junior Honor Society
 Student Name _______________________________________________ Date_____________

Name of Teacher Evaluator ______________ _______________________________________

Evaluation

Below Not
Criteria Excellent Average
Average observed
Leadership
Demonstrates initiative in promoting school activities
Positive influence and interaction with peers
Thoroughly dependable in any responsibility accepted and goes beyond the assigned tasks
A leader in the classroom and on campus
Service
Volunteers and provides dependable and well – organized assistance
Works well with others
Enthusiastically renders any requested service to the school
Participates in some activity outside of school
Shows courtesy by assisting visitors, teachers and students
Citizenship
Understands the importance of civic involvement
High regard for freedom, justice and respect of American form of government
Involvement in activities such as scouting, community organizations and school clubs
Discipline record
Character
Consistently exemplifies a positive attitude- cheerfulness, friendliness, poise, stability
Demonstrates the highest standards of honesty and reliability
Shows courtesy, concern, and respect for others
Cooperates by complying with classroom and school regulations
Manifests truthfulness in acknowledging obedience to rules e.g. avoiding cheating at written
work and unwillingness to gain from someone’s mistakes
Takes criticism willingly and accepts recommendations graciously
Observes instructions and rules both inside and outside of classroom
Upholds principles of morality and ethics
Based on your overall evaluation of these NJHS criteria, do you have any compelling reason to recommend or not recommend this
student for membership in the NJHS?

Teacher signature ____________________________________________________ Date

_________________