Course Selection Form

Course Selection Form
Student Name
First NameLast Name
Student ID
Grade Level
Term
School Year
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Parent/Guardian Name
First NameLast Name
Parent/Guardian hone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email
example@example.com

Main Course (Please select only 5 courses)

Rows	Day	Time	Take this?
BIO101 - Biology and Physiology
ECO101 - Economics
LIT101 - Literature
IM101 - Integrated Math
IMA101 - Integrated Math Advanced
CHE101 - Chemistry
PEX 101 - Physics
SOC101 - Social Science
ENV101 - Environmental Science
SPA101 - Spanish Language
JAP101 - Japanese Language
PEX101 - Physical Education
ACT101 - Acting/Theater
MUS101 - Music Theory
PSY101 - Psychology
CMS101 - Computer Science
ART101 - Fine Arts

Alternate Course (Please select only 5 courses)

Rows	Day	Time	Take this?
BIO101 - Biology and Physiology
ECO101 - Economics
LIT101 - Literature
IM101 - Integrated Math
IMA101 - Integrated Math Advanced
CHE101 - Chemistry
PEX 101 - Physics
SOC101 - Social Science
ENV101 - Environmental Science
SPA101 - Spanish Language
JAP101 - Japanese Language
PEX101 - Physical Education
ACT101 - Acting/Theater
MUS101 - Music Theory
PSY101 - Psychology
CMS101 - Computer Science
ART101 - Fine Arts

Student Signature
Clear
Date Signed
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent Signature
Clear
Date Signed
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

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