Download First Name: Last Name: Student ID Number: Year in School: Verify

First Name:
Last Name:
Student ID Number:
Year in School:
Verify: You understand that membership in an LT club is defined as being active with attendance and/or participation at least 50% of the time.
Co-Curricular Activities:
Please list any activities that you have been actively involved in at LTHS.
Activity, Sport or Organization
Year(s) in School
Adult Sponsor Name
Sponsor Email
Leadership Positions:
Please list any official leadership positions you have held in your co-curricular activities.
Activity, Sport or Organization
Leadership Position
(briefly describe your position)
Year(s) in School
Adult Sponsor Name
Sponsor Email
Community Activities:
Please list any community service you participated in over 1 hour.
Community Volunteer
Activities (not paid work)
Year(s) in School
Explanation of Services (What did you
do/accomplish? Describe time committment hours,
days, months, years, etc.)
Adult Sponsor Name
Honors and Awards:
Including academic department honor societies, all one day leadership opportunities (WSC, IDSA workshop, IHSA, etc.).
Honor/Award Name
Date Received
Describe why you achieved this honor/award, briefly.
Sponsor Contact Info
(Email/Phone)
Applicant Personal Statement:
National Honor Society is an organization dedicated to recognizing and rewarding students who demonstrate the four pillars of NHS: Scholarship; Leadership, Service, and Character. Include
in your personal statement how you have previously demonstrated these attributes and your plans going forward as a member of this society.