* 1. Student Name 

* 2. Parent/Guardian Name

* 3. Will your student attend Keithley Middle School next year?

* 4. Elective Preferences

Students may choose year-long band or choir or may choose the elective “sampler” where they will be enrolled in a variety of electives in 6th grade. (Participation in band or choir does include a few evening performances.) All 6th graders will take PE for ½ of the year.

Please indicate elective preference:

* 5. If BAND, select instrument:

* 6. Advisory Interest

All students start their day in an advisory class where they prepare for conferences and build community. All advisories will have the same curriculum but students will build community based on a common interest. Please indicate your 1st through 5th top interests in the following by placing “1” next to your favorite and so on.  
ONLY indicate #1-5.