Omni Middle School 8th Grade Elective Course Selection Form

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Student Last Name *

Student's Legal Last Name

Student First Name *

Student's Legal First Name

Student Number *

If new to the School District of Palm Beach County, please enter "00123456" below

Date of Birth *

Please enter in the following format: MM/DD/YYYY

Home Address *

Please Include City, State, and Zip Code

Parent/Guardian Name(s) *

Primary Phone Number *

Cell Phone Number *

Parent Email Address *

(Check if Applicable)

504

ELL (ESOL)

EP (Gifted)

IEP

Current or Last School (2020-2021)

** You may only submit one course selection form **

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