Primary Parent or Guardian's Name & Phone Number: *
Your answer
Primary parent or guardian's relationship to the child: *
Required
2nd Parent or Guardian's Name & Phone Number:
Your answer
2nd parent or guardian's relationship to the child:
Do you and your child live in the Elmore City - Pernell School District? *
Student's current address:
Your answer
1st Emergency Contact (name, relationship to student, phone number): *
Your answer
2nd Emergency Contact (name, relationship to student, phone number): *
Your answer
Do you plan on moving over the summer?
Clear selection
Select one or more of the following races. *
Required
Student's Grade in the '19-'20 school year *
Choose
6th
7th
8th
Please rank your choices for electives in order of preference from 1-4 with 1 being the most desired elective. Understand, you may not get your top choices but we will try our best to accommodate you.
1st Choice
2nd Choice
3rd Choice
4th Choice
6th - 8th Girl's Athletics
6th - 8th Boy's Atheletics
Academic Achievement *(assigned)
6th Band - Woodwinds/Percussion or
6th Band - Brass
7th Band
8th-12th Band
7th - 8th Career & Tech. Ed
7th - 8th Music Composition
6th Grade Character Education
Computer Applications - 6th
Computer Applications - 7th
Computer Applications - 8th
6th - 8th Health & Archery
7th-8th Life Skills
6th - 8th Performing Arts (drama, vocals, etc.)
7th & 8th American Sign Lang.
8th Spanish I (HS Credit)
6th - 8th STEAM (Sci, Tech., Eng., Art, Math)
8th Grade Vocational Agriculture
1st Choice
2nd Choice
3rd Choice
4th Choice
6th - 8th Girl's Athletics
6th - 8th Boy's Atheletics
Academic Achievement *(assigned)
6th Band - Woodwinds/Percussion or
6th Band - Brass
7th Band
8th-12th Band
7th - 8th Career & Tech. Ed
7th - 8th Music Composition
6th Grade Character Education
Computer Applications - 6th
Computer Applications - 7th
Computer Applications - 8th
6th - 8th Health & Archery
7th-8th Life Skills
6th - 8th Performing Arts (drama, vocals, etc.)
7th & 8th American Sign Lang.
8th Spanish I (HS Credit)
6th - 8th STEAM (Sci, Tech., Eng., Art, Math)
8th Grade Vocational Agriculture
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