Convention Registration 2013

GANHS Convention Registration Form

                Any chapter planning to attend the convention must first pay the appropriate state dues. The postmark deadline is March 29, 2013.  All late registrations require a $10.00 late fee per person, in addition to the regular registration fee. Any substitution made will require a $5.00 substitution fee.  Please direct any questions to:  Hannah Taylor, State President  hannah.taylor9254@gmail.com

All payments should be in the form of School Checks.

School Name        _____________________________                            Mail Forms To:   Alfredia Braylark

4640 Raiders Ridge Lane

Lithonia, GA 30038                            

Advisor’s Name  ______________________                                                  

School Address   ______________________                               

                   ___________________       

School Phone       ______________________________________                                                      

E mail address     ____________________________________________________

Total Number of People Attending including State Board          ____________________

Total Number of People Attending (Students/Advisors/Chaperones)      ___________________ (x $90.00)

Late Fees (If Applicable)                                                                   ____________________ (x $10.00)

Substitution Fees (If Applicable)                                                      ____________________ (x $5.00)

Total Registration Fee                                                                                        _________________

               

      Convention T-Shirts     _____ SM   _____MED    _____ LG   _____ XLG  _____ XXLG     _____ XXXLG

Please Print All Names Clearly

Names of all VOTING DELEGATES (1 per every 10 members, or major fraction thereof)

1.   _______________________________________                               7.   _________________________________________   

2.   _______________________________________                8.  __________________________________________    

3.   _______________________________________                9.  __________________________________________    

4.   _______________________________________               10.  __________________________________________    

5.   ________________________________________            11.  __________________________________________    

6.   __________________________________________        12.  __________________________________________    

Name of all NON-VOTING DELEGATES:

1.    _____________________         7.   ________________________

2.   _____________________           8.  _________________________

3.   _____________________           9.  _________________________

4.   _____________________         10.  _________________________

5.   _____________________         11.  _________________________  

6.   _____________________         12.  __________________________  

Names of ADVISORS AND CHAPERONES: (please specify: 1 per every 10 members) Chaperones must be faculty or parents of students attending. Other chaperones must be approved by State Board.

(Advisor)               ___ ____________________________________________________  

(Advisor)               _______________________________________________________  

Additional Chaperones (if applicable _______________________________________

Candidate (if applicable)   __________________________________________   

Campaign Manager                            __________________________________________   

Name State Board Members Attending                          _________________________________________ (Registration Fee Exempt)   

Name of State Board Advisor Attending                        _________________________________________  

PLEASE NOTE: Candidates, Campaign Managers, and State Board Members may not serve as voting delegates at the convention.  

Scholarship Application 2013

Georgia National Honor Society Scholarship

Postmark Deadline:  March 39, 2013

(This form may be photocopied)

Scholarship Requirements:

• Senior
• NHS Member
• Attended a GANHS State Convention
• School is an active member of GANHS (to be confirmed by GANHS Treasurer)

General Instructions: 

Two seniors from the same school can apply for this scholarship. 

Answer all of the following questions to the best of your ability and follow the instructions completely.  Be careful not to duplicate your responses.  The selection of the scholarship will be influenced by the completeness of the replies, neatness, and legibility.  Please type or print, using black ink.  Submit three (3) complete packets for each applicant.   Each packet must contain a copy of the application, an official school transcript, and a letter of recommendation.  The application fee for one or two applicants is $10.00 which must be submitted in the form of a check from your school made payable to Georgia Association of National Honor Societies or GANHS. 

It is very important the all instructions have been met for this scholarship. 

Incomplete packets will not be considered for the scholarship.

Mail all forms to:

Evelyn Lewis

GANHS Scholarship

3950 McWilliams Trace

Acworth, GA 30101

GANHS SCHOLARSHIP APPLICATION

I.       General Information

Name:  ________________________________________             Birthdate:  __________

Address:   _______________________________________________________________

City:  _____________________________          State:  ______   Zip Code: ___________

Home Phone:  (____)  ____-_____________

Email:  ____________________________________________________

School Name: ___________________________________________________________

School Phone: (____) ____-______________

School Fax Number: (____) _____-_______________

Advisor’s Name:  __________________________________________

Year(s) of Convention Attendance:   ________     __________     __________

II.    Academic Information

GPA:   _______ on a  ______scale.  This GPA is: ___________ (weighted/un-weighted)

Class Rank:    Number ________ in a class of __________.

Senior Year Schedule:

            (All courses taken during your senior year; indicate Honors or Advanced Placement)

Testing (SAT or ACT is required, ACH is optional)

SAT:    Math _________      Verbal _________Writing ________Date _____________

            Math _________      Verbal _________Writing ________Date _____________

ACT:   EN _________ MA _________ R _________ SC _________ Date ___________

ACH:  Test:  ____________________ Score __________________  Date ___________

Please list any academic honors or distinctions you have received in your four years of high school:

III.  Extracurricular Information

In order of importance to you, please list your major extracurricular pursuits (personal, religious, athletic, community, etc) with honors won and/or positions held while in high school.  You may attach a separate sheet to the application if your reply exceeds the space provided. (Remember to include three copies)

Ex. National Honor Society (10, 11, 12), Secretary (11), Outstanding Member (11)

           

List any jobs you have held while in high school.

Employer:_________________________________________________________

            Position:   _________________________________________________________

            Dates Employed:          From:  ___________    To: __________

            Hours per week:  ____________

Employer: ________________________________________________________

            Position:  _________________________________________________________

            Dates Employed:          From:  ___________    To: __________

            Hours per week:  ____________

In the space provided, describe how you have served your local NHS chapter.  We are especially interested in any community service in which you have participated through your local chapter.

In the space provided, indicate which factors should be considered if you were tied with another person for this scholarship.

IV. Personal Goals

In the space provided, describe your goals and aspirations:

V.  Essay and Recommendation

On a separate sheet of paper, tell us something about yourself that we might not learn from the rest of your application.  You may write on any topic that you feel will give us a better impression of you.  Type and double-space the essay, limiting your response to 800 words.

Include a letter of recommendation from a teacher who knows you well.

VI. Signatures

Applicant’s Signature:  ___________________________________  Date:  ___________

Advisor and Principal:  I am aware that this nominee is applying for this scholarship, and approve of his/her nomination.  I also certify that this nominee is a member, in good standing of the NHS chapter at my school, and that his/her description above is accurate.

Advisor’s Signature:  _____________________________________  Date:  __________

Principal’s Signature:  ____________________________________  Date:  __________

Participant Form 2013

Georgia Association of National Honor Societies

2013 State Convention

Participant Commitment Form

Dear Parent/Guardian:

We are delighted that your son or daughter will be attending the Georgia National Honor Society State Convention at the Jekyll Island Inn on Jekyll Island.  Because we wish to ensure the safety of your student, as well as other participants and hotel guests, we have developed the following guidelines.

All delegates are expected to:

1.      Attend all convention sessions at the designated times and places, accompanied by a school advisor or chaperone.

2.      Respect the rights and safety of others.

3.      Be courteous to other guests in the hotel and honor their privacy and need for rest in sleeping room areas. Quiet time in the sleeping room area begins at 12:00 A.M.

4.      Observe the convention-stipulated curfew. Members must be in their own room at curfew. The advisor and principal are responsible for supervision and will be notified of students breaking curfew.

5.      Under no circumstances are male or female delegates to be in the hotel room of the opposite gender without an adult present.

6.      Understand that the use of alcohol or illegal drugs is strictly prohibited.

7.      Always display the appropriate mode of behavior and attire, which is representative of any honor society position.

8.      Unsupervised students may not leave the hotel at any time.

9.      All students are to respect the property of others. Students are not to take objects away from the hotel rooms, conference areas, or any other property visited. Theft and vandalism will not be tolerated. Any damages done will be at the student’s expense.

10.  Wear appropriate convention name tag and identification at all convention activities.

Any violation of these guidelines will result in your student being sent home at his or her expense. Of course, we would much prefer that everyone have an exciting and safe convention. We appreciate your support of your student’s involvement in leadership development. Your signatures below indicate that you have read the above guidelines and are in agreement with these expectations. Thank you.

Media Release Section:  By signing below, you release the right to utilize any photos taken at the

  GANHS convention for promotional purposes, mainly by means of http://georgianhs.blogspot.com/

Parent/Guardian Signature _________________________________            Date   ______________

Student Signature            __________________________________             Date  ______________

School Name _______________________________   Home Phone # (____)_____________

Candidate for State Office

GANHS Convention Candidate Registration Form

The purpose of this from is to let us know who you are and what position you would like to run for at the convention. The GANHS State Board has seven offices: President, Vice-President, Recording Secretary, Corresponding Secretary, Treasurer, Media Representative and Chaplain. We encourage all candidates to attend at least one state board meeting in order to learn the responsibilities of all members. If you need more information, please contact hannah.taylor9254@gmail.com

A Display may be set up at the convention center after 4PM Sunday. A science fair type tri-fold display board will be the only acceptable board. Each officer will be allowed one display board only. No items such as candy, buttons, etc may be given away at the display. Tables will be provided. You may make campaign T-shirts or other promotional material that can only be worn by members of your chapter. You also need to make an 81/2 by 11 campaign flyer, which will be distributed in the folders by the state board at the convention. You will be given five minutes to address each voting caucus at convention, so you should write a short speech to present at this time. Remember to allow some time for the delegates to ask you questions. You should also select a campaign manager to introduce you to each caucus. Please complete this form and mail it to ATTN:  NHS Hannah Taylor  6500 Alexander Parkway Douglasville GA 30135.  We wish you success and please do not hesitate to contact any of the State Board Advisors if you have any questions.  Please print 75 flyers and mail to:  Alfredia Braylark 4640 Raiders Ridge Lane Lithonia, GA 30038

Please print or type:

Name: ______________________________________________________________________

Mailing Address: _____________________________________________________________

____________________________________________________________________________

Phone Number:  ____ ____ _______ Email:_________________________________________

School: _______________________________________________________________________

Office (Check one) ___President ___Vice-President ___Recording Secretary

 ___Corresponding Secretary ___Treasurer ___Chaplain ___Media Representative

Your signature constitutes a pledge to abide by all campaign rules and fulfill the duties of your office if elected.

Candidate’s Signature :__________________________________________ Date: __________________

Your signature constitutes a pledge to accompany your officer to all GANHS state meetings and to supervise your officer’s duties.

Advisor’s Signature: ___________________________________________________________________

I release the above mentioned candidate and advisor as needed to attend GANHS State Meetings.

Principal’s Signature_____________________________________________________________________

Hotel Form for Convention 2013

GANHS

Georgia National Honor Society

April 14 – 16, 2013

Oceanside Inn and Suites, Jekyll Island, GA

Name_________________________________ Daytime Phone_______________________

School_____________________________________

Address_____________________________City___________________State/Zip_____________

Arrival Date: _________________________Departure Date: ___________________________

Number of Adults: ____________________    Number of Students: ______________________

Guest Room Rate:                     Islandside Guestrooms -     $85.00

                                                Oceanfront Guestrooms -    $105.00

                                                Superior Guestrooms -        $122.00

                                                Oceanfront Efficiency -        $140.00

                                                 Lanai Room -                     $155.00

Currently our room tax is 11% and $8.56 resort fee per room, subject to change according to government regulations.

GA tax exempt forms required with tax exempt status  (resort fee $8.00 per room with tax exempt forms)

Island Side Guestroom                     Standard guestroom on island side of hotel

Oceanfront Guestroom                    Standard guestroom on ocean side of hotel

Superior Guestroom                         Oversized oceanfront guestroom with microwave, small refrigerator and private patio or balcony

Oceanfront Efficiency                      Oversized oceanfront guestroom with kitchenette, stove top, microwave, refrigerator and private balcony or patio

Lanai Guestroom                               Oversized oceanfront guestroom with Jacuzzi and private balcony or patio

An advance deposit for one night’s room plus tax & resort fee is required prior to arrival to reserve your preferred accommodations.  No reservations will be accepted without a deposit.  After March 29, 2013, reservations are subject to

space availability.  Deposits are refundable if cancellation is received 48 hours prior to arrival.

Deposits can be made by credit card, personal check, company check, or cashier’s check.

NUMBER OF ROOMS REQUESTED___________     TYPE(S) OF ROOM(s) REQUESTED_____________________________

CREDIT CARD TYPE_________________NUMBER_________________________________________________________________

EXPIRATION  DATE___________________AUTHORIZED SIGNATURE______________________________________________

                                                          **Credit cards will be processed upon receipt**

                                                            *All major credit cards accepted*

Please complete and return to:  Oceanside Inn and Suites

                                              711 North Beachview Drive

                                              Jekyll Island, GA 31527

All reservation forms should be sent to the attention of :  Holly White

If calling in Reservations, please speak directly with the Front Desk:

Phone: 866-553-5955 or 912 -635-2211

Fax: 912-635-4732

State Dues 2013

All clubs who are affiliated with the GANHS and the National Honor Society are required to pay state dues.  State dues are $3.00 per club member.  

State Dues Form. Please submit ASAP.  

Copy and paste the form into a word document.  

Georgia Association of the

National Honor Society

www.georgianhs.blogspot.com

2012 -2013 Annual Dues Form

*Make checks payable to the Georgia Association of National Honor Societies.

** School checks ONLY.

School Name: ______________________________________________________

School Address: ____________________________________________________

__________________________________________________________________

School Phone:______________________________________________________

Advisor(s): ________________________________________________________

__________________________________________________________________

Advisor(s) email:____________________________________________________

__________________________________________________________________

Total number of members   _________    X    $3.00       =  __________

Please enclose a type roster of the NHS chapter members.

Mail to:

Alfredia Braylark

4640 Raiders Ridge Lane

Lithonia, GA 30038

Convention 2013: Road Trip!!!!!!

Convention will be April 14-16 on Jekyll Island. 

State officers report April 13th. 

For more information email carrie.cochran@douglas.k12.ga.us or hannah.taylor9254@gmail.com