Course Selection Form
Student Name
First Name
Last Name
Student ID
Grade Level
Term
Fall
Spring
Summer
School Year
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Name
First Name
Last Name
Parent/Guardian hone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
Main Course (Please select only 5 courses)
Day
Time
Take this?
BIO101 - Biology and Physiology
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
ECO101 - Economics
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
LIT101 - Literature
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
IM101 - Integrated Math
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
IMA101 - Integrated Math Advanced
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
CHE101 - Chemistry
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
PEX 101 - Physics
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
SOC101 - Social Science
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
ENV101 - Environmental Science
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
SPA101 - Spanish Language
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
JAP101 - Japanese Language
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
PEX101 - Physical Education
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
ACT101 - Acting/Theater
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
MUS101 - Music Theory
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
PSY101 - Psychology
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
CMS101 - Computer Science
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
ART101 - Fine Arts
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
Alternate Course (Please select only 5 courses)
Day
Time
Take this?
BIO101 - Biology and Physiology
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
ECO101 - Economics
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
LIT101 - Literature
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
IM101 - Integrated Math
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
IMA101 - Integrated Math Advanced
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
CHE101 - Chemistry
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
PEX 101 - Physics
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
SOC101 - Social Science
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
ENV101 - Environmental Science
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
SPA101 - Spanish Language
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
JAP101 - Japanese Language
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
PEX101 - Physical Education
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
ACT101 - Acting/Theater
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
MUS101 - Music Theory
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
PSY101 - Psychology
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
CMS101 - Computer Science
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
ART101 - Fine Arts
Yes
No
7:00AM-12:00NN
1:00PM-6:00PM
Yes
No
Student Signature
Date Signed
-
Month
-
Day
Year
Date
Parent Signature
Date Signed
-
Month
-
Day
Year
Date
Submit
Should be Empty: