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Provo City School District

Wasatch Elementary School

The Wasatch Honor Patch is the highest award you can earn. To qualify you must be in 3rd grade or above and meet all of the requirements on this application and get the necessary signatures when you have completed each section. You are responsible to keep this application in a safe place. Turn completed application into the office no later than the last school day in April. (30th )

(Applications will NOT be accepted late.)


 Is responsible for own actions.  Shows respect and consideration for others.  Has not been involved in any disciplinary action this school year. _______________ ____________________ _______________ Teacher Playground Supervisor Principal


 Tries to master assignments independently.  Takes responsibility for class work and homework.  Maintains 85% achievement in all academic areas.  Asks for help when needed. _______________ Teacher


Participate in three school activities:

 Great Brain  STAR Reading Challenge  Writers’ Olympics  Band  Spelling Bee  Concert Choir  3rd Grade Choir  Talent Show  Science Fair  Track & Field Day  Art Expressions  Garden Club  Drama Production  Kindness Club  Hope Squad  Dance Club  Chinese  Yo-Yo Club  Battle of the Books _______________ Activity Signature


 Demonstrate respect during flag ceremony.  Sing the first verse of the Star-Spangled Banner.  Complete the requirements for your grade as listed. (Specific quotes and words are enclosed.)

3rd Grade

 Memorize quotes by Benjamin Franklin, Abraham Lincoln and John F. Kennedy.  Recite or sing God Bless America.

4th Grade

 Memorize quotes by Patrick Henry, Benjamin Franklin and Abraham Lincoln.  Recite or sing first and fourth verses of America The Beautiful.

5th Grade

 Memorize quotes by Abraham Lincoln and Thomas Jefferson (Declaration of Independence)  Recite the Preamble to the Constitution.  Recite or sing the first and fourth verses of America.  Know the rules on how to display the flag.

6th Grade

 Memorize quotes by Benjamin Franklin or Robert Kennedy.  Recite or sing the first and last verses of the Star-Spangled Banner.  Know the rules of how to display the flag.  Write a five-paragraph essay: “What I Can Do To Keep America Great.” ___________________ and ___________________ Teacher Principal The principal will sign the application after it is turned into the office and has been reviewed.


Give service at home or in your neighborhood for a min. of THREE hours. Service must be pre-approved by the person who signs verification. (Minimum of 15-minute increments.)

Date Length of Time Service Rendered Initials

Note: Completion of service hours is only one part. You must also complete the requirements in the other four categories. Check with your parent on citizenship and academic requirements to be sure you qualify before applying.


The deadline for the Great Brain, STAR Reader and Caldecott Challenge is fast approaching – mark your calendars for Monday, May 6th! Please remind your student that forms forms are due by the end...

We want to thank all the dads and father figures who volunteered at Wasatch last week. Your support greatly influences the lives of our students and has a meaningful impact on our community. Wasatch...

Come to our Wasatch Elementary Family STEM night April 25th from 6:30-8:00! We will have presenters teaching about Science, Technology, Engineering, and Mathematics. There will be over 20 activities...