National Honor Society - Laurel Springs School Family Center

National Honor Society
Character Reference Form for the National Honor Society
Student’s Full Name: _____________________________________________________________ Grade: _________
I understand that this character reference is confidential and will not be released to myself, family, or a third party,
and it will be used only in the evaluation of my candidacy for Laurel Springs School’s Chapter of the National
Honor Society.
Student’s Signature: ______________________________________________________ Date: ___________________
Instructions for Recommender
The person completing this Character Reference should be an adult [non-relative] who has supervised the student
in some specific activity of service or leadership. We are interested primarily in the student’s character, proven
service record, and the ability of the student to be a leader in his or her community. We value your comments
and insight regarding this student. Your opinion is very important to us and will be an integral element in our
decision process.
Recommender’s Name: _______________________________________________________________________
Title (if applicable): __________________________________________________________________________
Email: ____________________________________________ Phone Number: ____________________________
Signature: _______________________________________________________ Date: _____________________
Rating
Compared to other students, how would you rate this student in terms of the following? (Please use a X to
denote rating.)
Below Average
Acceptable
Above Average
Excellent
Outstanding
No Basis
Personal
Qualities and
Character
Leadership
Service
Record
Academic
Achievement
Overall
LaurelSprings.com
(800) 377-5890
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National Honor Society
As you answer the following questions regarding the named student, please be specific.
1. How long have you known this student and in what context?
2. How would you describe this student’s character, personal qualities, and maturity level?
3. How has the student demonstrated leadership qualities?
4. How has the student contributed to the community, either on a local or global level?
5. Is there anything else you think we should know about the student that would contribute to his or her application?
This form is due by April 1, 2015
Please return via email to: [email protected]
Or mail to: Laurel Springs School, Attention: National Honor Society
1615 West Chester Pike, Suite 200, West Chester, PA 19382
LaurelSprings.com
(800) 377-5890
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