ECPS Required *HS Student Info. Forms '19 - '20
Email address *
Student's Last Name *
Your answer
Student's First Name *
Your answer
Student's Date of Birth *
Parent or Guardian's Name & Phone Number: *
Your answer
Do you and the above student live in the Elmore City - Pernell School District? *
Student's current address:
Your answer
Do you plan to move over the summer?
1st Emergency Contact (name, relationship to student, phone number): *
Your answer
2nd Emergency Contact (name, relationship to student, phone number): *
Your answer
Select one or more of the following races. *
Student's grade for the '19-'20 school year *
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. Only pick ONE for each Column.
1st Choice
2nd Choice
3rd Choice
4th Choice
American Sign Lang. I
American Sign Lang. II (prerequisite)
Spanish I
Spanish II (Prerequisite)
Technology Education
HS Band
Boy's HS Atheletics
Girl's HS Atheletics
Computer I
Computer II (Prerequisite)
Religious History
Yearbook (submit application to Ms. Wallace)
Teacher or Office Aid (see Ms. Henry)
HS Agriculture
Ag Mechanics (Prerequisite)
Vocal Music
Internship (Seniors Only, 2-3 hours, must be accepted to program)
Senior Service Project (Seniors, must be approved by Mr. Willis only)
Mid-America Tech Center (Juniors/Seniors only)
Concurrent College Classes(see Mrs. Henry, must have 19 on ACT)
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