6th Grade Enrollment Form Question Title * 1. Student Name Last name First name Question Title * 2. Parent/Guardian Name Last name First name Question Title * 3. Will your student attend Keithley Middle School next year? Yes No Question Title * 4. Elective PreferencesStudents 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: Elective Sampler (may include Art, Leadership, Technology, and Music) Choir (year-long commitment) Band (year-long commitment) Question Title * 5. If BAND, select instrument: French horn Trumpet Trombone Alto Saxophone Baritone Tuba Flute Tenor Saxophone Clarinet Bass Clarinet Percussion Question Title * 6. Advisory InterestAll 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. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Art 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Music (listening to) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Music (singing or playing) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Reading 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Sports 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All boys group 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 All girls group 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Video games 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Diversity/Culture 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Fashion/Style 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Writing/Poetry 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Friendship/Leadership 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Social Justice/Current Events 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Fitness/Exercise/Nutrition 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Science/Engineering 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Travel/Discover the World Done