Essay for ExCel Award though Mn State High School League
Instructions:
1) I need to give a favorite quote
2) 50 words or less define leadership from a 17 year-old high school student
3) In 250 words or less, describe how one of my volunteer experiences benefited myself and others.
This is the list of two of the volunteer experiences I thought would be best for essay topic
Sunday Bible School – 3 years thru Kindergarten
Nursing Home Bingo – helped residents with Bingo
STUDENT NOMINATION FORM
To be eligible for the ExCEL Award, students must:
1. be a junior in high school
2. make satisfactory progress toward graduation requirements
3. participate in a League-sponsored fine arts and/or athletic activity
4. hold a leadership position in their school
5. work voluntarily in their community
6. meet MSHSL General Eligibility Requirements (Bylaw 206)
INSTRUCTIONS
• Type all information and answer all questions in the space provided. Handwritten applications will not be accepted. Addendums will not be accepted
• Please provide all information requested!
• Do not use acronyms or abbreviations
• Complete one form for each student (ONE BOY AND ONE GIRL) nominated from your school
• Include with each nominee’s form:
• One-page letter of recommendation written by a school staff member (see form provided).
• Student essay (see form provided)
• One wallet-size photo of student – DO NOT staple or paper clip picture to this form. Please include the student name and school on all photos
• Return nomination form(s) to the MSHSL ExCEL, 2100 Freeway Blvd., Brooklyn Center, MN 55430, postmarked no later than December 14, 2012 Winners will be notified of their selection via League website on February 1, 2013
STUDENT/SCHOOL INFORMATION MSHSL Administrative Region Class A or AA
Student’s Name Alissa Mae Stueve
School Name Clinton-Graceville-Beardsley
School Street Address 712 West Third Street Graceville 56240
P.O. Box City Zip
School Phone Number 320 748-7233 Fax Number 320 748-7159
Principal’s Name Larry A. Mischke Email: [email protected]
Athletic Director’s Name Mike Piechowski Email: [email protected]
Was the student a participant in a school safety patrol program in elementary school? Yes __x__ No ____
Student’s Parent(s)/Guardian(s) Terry and Deb Stueve
Student’s Home Address 6710 County Road 4 Dumont 56236
P.O. Box City Zip
Home Telephone Number 320 760-4499
Home Town Newspaper And Address The Northern Star
Newspaper Telephone Number 320 325-5152 Fax Number 320 325-5280
Newspaper Email Address [email protected]’s Name Mike Piechowski Email [email protected]
Title Activities/Athletic Director
Nomination Checklist
This nomination becomes complete and valid only when you have submitted:
nomination form
student photo – DO NOT staple to this form
student essay
letter of recommendation
PARTICIPATION IN INTERSCHOLASTIC ACTIVITIES (* = FALL ACTIVITIES ONLY)
MSHSL ATHLETIC ACTIVITIES Grade Awards/honors, records, outstanding
(list sport once w/awards) 9 10 11* performances, leadership roles, etc.
Volleyball X X X
Junior Varsity X
Varsity X All Conference; Most Valuable Player; Most Kills
Girls Basketball X X
Junior Varsity X
Varsity X All Conference Honorable Mention
Varsity Track X Team Conference Champions
4 x 800 X 1st Place
4 x 400 X 1st Place
800 Meter X 2nd Place
Discus X 3rd Place
Softball
Varsity X
(* = Fall Activities Only)
FINE ARTS ACTIVITIES Grade wk/mo/yr Awards/honors, records,
(list activity once w/awards) 9 10 11* HOURS outstanding performances, leadership roles etc.
Senior High Band X X X 3 yr 3 mo
Clarinet Solo X X 2 years Excellent
Large Group X X 2 years Excellent
Jazz Band X 1 year
Small Group – Saxaphone X 1 year Excellent
Pep Band X X X 1 yr 3 mo
GENERAL CONTRIBUTIONS TO SCHOOL (* = FALL ACTIVITIES ONLY)
Grade wk/mo/yr
Activity 9 10 11* HOURS Offices held, awards/honors, leadership roles, etc.
Honor Roll (Indicate A or B) “A” X X X Rank #2
“A” Honor Role X 4 quarters
“A” Honor Role X 4 quarters
“A” Honor Role X 1st Qrt
Class Officer X 1 year Vice President
Student Council X X 1 yr 3 mo
Sports Concessions X X X 2 yr 1 mo Football and Boys Basketball
VOLUNTEER COMMUNITY SERVICE (* = FALL ACTIVITIES ONLY)
Total Hours Grand
Grade Total
Activity 9 10 11* Hours Offices held, awards/honors, leadership roles, etc.
Church Fall Dinner X X X 16
Ditch Clean-up X X 4
Sunday Bible School X X X 18
Spring Fling X X 8
Graceville Women’s Turkey Bingo X 2
Santa Days X 2
Nursing Home Bingo X X 8
Nursing Home Christmas X 2
GRAND TOTAL HOURS 70
PRINCIPAL CERTIFICATION
The student named on this nomination form is currently a high school junior, has been enrolled in high school for the last five semesters, and is designated to represent our school as its ExCEL student winner.
Principal’s Signature Date
sr:g:ex.fm nomination – table 11/30/2012
ExCEL Student Essay
Name Alissa Mae Stueve School Clinton-Graceville-Beardsley Schools
1. Please give us your favorite quote:
2. In 50 words or less, provide us with your definition of Leadership: _________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
3. In 250 words or less, please choose one volunteer experience listed on your application and describe how the experience benefited yourself and others. The essay must be one-sided, typewritten, and double-spaced on this form.
ExCEL Award Letter of Recommendation
(written by school staff member)
Student (first & last name) Alissa Stueve School Clinton-Graceville-Beardsley Schools
Written by (name & title)
In 250 words or less, please explain how the student positively influences others. Please be sure to describe the student’s leadership skills. Letter must be one-sided and typewritten on this form.
Nomination Form Instructions
• TYPE ALL INFORMATION AND ANSWER ALL QUESTIONS IN THE SPACE PROVIDED.
• Complete the nomination form and submit it to the Minnesota State High School League by the date specified on the nomination form.
• Please list all of the activities in which the student is involved. Below are sample activities you may list on the nomination form. Do not use acronyms or abbreviations.
• Indicate the number of hours involved in each activity per week, per month, or per year (i.e. 10/wk). Include only those activities that require eight or more hours per week, per month, or per year.
• When completing the ExCEL nomination form please consider the following:
Athletic Activities
List each MSHSL athletic activity in which the student participates. Please include the following information:
• Team captain
• All-conference honors
• All city/metro honors
• All-tournament teams
• Number of years on team
• School/team awards
• Team academic awards
• Team member or manager
Fine Arts Activities (School/Community)
Any involvement in state, section, sub-section, school or community-sponsored activities such as instrumental/vocal music, drama, debate, speech, or visual arts. Write “class” in the “hours” column if the activity is part of your course work.
• Band (includes marching, jazz, and pep)
• Choir
• Orchestra
• Debate
• Speech
• One Act Play
• Visual Arts
• Lead/major role in play/musical
• Student director of a play/musical
• Soloists
• First chair or section leader in music
• Best of Site awards
• Participation in select music groups (e.g. show choir, jazz band)
• Participation in one or more fine arts activity
• MN Youth Orchestra
• Number of years in activity
General Contributions to School:
This category includes non-League-sponsored activities, which may include, but are not limited to, the activities listed below. Write “class” in the “hours” column if the activity is part of your course work. Please include length of service and offices/positions held if applicable.
Academic Quiz Bowl
Academics Decathlon
Future Problem Solving
Honor Roll
Inroads
Knowledge Bowl
Language Clubs
Math League
Multi-Cultural Programs/Clubs
National Honor Society
National Merit Finalist
National Merit Semifinalist
Odyssey of the Mind
Peer Tutoring/Counseling
Science Challenge
Spotlight on Scholarship Certificates
Scholar-athlete awards
Upward Bound
Other School Activities:
• Boys/Girls State Government
• Class officer
• Future Farmers of America
• Future Homemakers of America
• Key Club
• Mock Trial
• School musical
• School newspaper
• Student Council
• Yearbook staff
• Youth in Government
• Other school activities which require additional time to serving your school and/or student body.
Volunteer Community Service
Briefly describe the volunteer services in which the student(s) has participated without pay and that require the student to devote non-school time. Indicate the approximate number of hours involved in each activity. Please include only those activities that require eight or more hours per week/per month/per year (i.e. 10/mo). Grand total hours should be converted into hours per year.
Community Involvement:
• Civic, youth, and professional organizations
• Church involvement
• Hospital or health services
• Tutoring/coaching/mentoring
• Fundraising for a charitable cause
• Community theater
• Other community service projects which require non-school time to serving your community
(Continued)
SAMPLE SAMPLE SAMPLE
Nomination Form
* = 11th Grade – List Fall Activities Only
MSHSL ATHLETIC ACTIVITIES Grade Awards/honors, records, outstanding
(list sport once w/awards) 9 10 11* performances, leadership roles, etc.
Soccer X X X 03-04 Lettered
Varsity X X
Most Improved X
Spotlight on Scholarship X X Gold
Basketball X X 9th grade/B-squad captain
State Tournament X Participant
Spotlight on Scholarship X X Gold
Track: 4 x 4 relay X X State: 03/Silver; 04/Gold
FINE ARTS ACTIVITIES Grade wk/mo/yr Awards/honors, records,
(list activity once w/awards) 9 10 11* HOURS outstanding performances, leadership roles, etc.
Band, marching, pep X X Class
Jazz X X X 10/wk
Jazz X X 8/wk 03/Best of Site Award
Choir X Class Section leader
Ensemble X X 12/mo
Fall Play X X 8/wk
GENERAL CONTRIBUTIONS TO SCHOOL (* = FALL ACTIVITIES ONLY)
Grade wk/mo/yr
Activity 9 10 11* HOURS Offices held, awards/honors, leadership roles, etc.
Honor Roll (Indicate A or B) A A n/a
Academic Quiz Bowl X X
National Honor Society X X
Peer tutoring X X X 8/week
Spanish Club X X X 8/mo 03/Treasurer
Student Council X X X
Class Officer X 03-04 President
Homecoming committee X
Target Group X X
VOLUNTEER COMMUNITY Total Hours Grand
SERVICE Grade Total
Activity 9 10 11* Hours Offices held, awards/honors, leadership roles, etc.
Church 40/yr 40/yr X 80/yr Nursery work, preschool setup, Sunday School assistant, youth group, church choir
Adopt A Highway 8/yr 8/yr 16/yr
Meals on Wheels 10/mo X 120/yr+
Youth Soccer Coach 10/wk 10/wk 200/yr (10 week season)
Youth Soccer Referee 2/wk 2/wk 2/wk 60/yr (10 week season )
GRAND TOTAL HOURS 168 288 20 476
sr:h:ww:excel:fm nomination – table rev. 11/30/12
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